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Anticoagulant use is prevalent and associated with significant potential for harm. Anticoagulation stewardship practice has emerged to address care gaps and promote safe, effective, and cost-conscious anticoagulation use across health care systems. We present 4 patient cases describing common challenges in anticoagulation management: inappropriate dosing of direct oral anticoagulants, the diagnosis and management of heparin-induced thrombocytopenia, periprocedural anticoagulation management, and heavy menstrual bleeding on anticoagulation. We discuss available examples of successful stewardship programs that can address the challenges of each case, demonstrating how an investment in anticoagulation stewardship can improve patient outcomes.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11890946 | PMC |
http://dx.doi.org/10.1016/j.jtha.2024.11.024 | DOI Listing |
Nurs Adm Q
August 2025
Author Affiliations: Department of Nursing, Mayo Clinic, Rochester, Minnesota (Dr Mattson, Mr Timm, Mss Negley and Foster) and Department of Nursing, Mayo Clinic Health System (Ms Foster and Dr O'Connor).
Registered nurses possess specialized knowledge and skills applicable to the ambulatory setting, including complex medication management. This enables clinicians and pharmacists to see patients who need their expert skill set; fully optimizing the role of each member of the team, including scope. This article details a nurse-led anticoagulation program demonstrating successful patient outcomes and cost-effectiveness.
View Article and Find Full Text PDFInt J Pharm Pract
August 2025
Pharmacy Department, Royal Cornwall Hospitals NHS Trust, Cornwall TR1 3LJ, United Kingdom.
Objectives: This study explored how community pharmacies in the English National Health Service responded to a referral from one hospital in the south west of England for a discharge medicines service for patients on oral anticoagulants.
Methods: Analysis of PharmOutcomes™ for a 12-month period commencing 1 April 2023. The download was interrogated for relevant entries for patients discharged on apixaban, dabigatran, edoxaban, rivaroxaban, or warfarin.
Ann Pharmacother
August 2025
Department of Pharmacy, Wesley Medical Center, Wichita, KS, USA.
The reversal of anticoagulants can be a complex process with limited data describing the optimal overall approach beyond a specific reversal agent. Recent advances in anticoagulation stewardship have created opportunities to standardize and optimize the reversal of anticoagulants, especially in urgent life-threatening bleeding events. This article explores how pharmacists provided anticoagulation stewardship activities positively impact outcomes related to urgent anticoagulation reversal.
View Article and Find Full Text PDFJ Thromb Thrombolysis
July 2025
Department of Pharmacotherapy, University of Utah College of Pharmacy, Salt Lake City, UT, USA.
Care of patients with thrombosis requires application of rapidly advancing science, complex decisions balancing risks and benefits, interpretation of multiple data sources, and coordination across fields. To meet these challenges, we describe our collaborative meeting for discussion and coordination of complex thrombosis cases, the Clot Cases Conference. Based loosely on the tumor board model from oncology, we describe the multidisciplinary nature, with attendees from multiple disciplines and institutions, and hybrid format, including both case- and topic-based sessions.
View Article and Find Full Text PDFCan J Hosp Pharm
July 2025
, BSP, PharmD, is a Professor with the Division of General Internal Medicine, University of Alberta, Edmonton, Alberta.
Background: Venous thromboembolism (VTE) events occur in association with COVID-19, and the optimal duration of anticoagulant treatment is uncertain.
Objectives: The primary objectives were to determine the duration of anticoagulant prescriptions filled after COVID-19-associated VTE and the proportion of patients experiencing VTE recurrence. The secondary objective was to determine the proportion of patients who experienced bleeding events.