Incorporating Comprehensive Management of Direct Oral Anticoagulants into Anticoagulation Clinics.

Abstract:

:Anticoagulation clinics emerged as a means to optimize warfarin effectiveness and minimize bleeding risks. Anticoagulation clinics have traditionally been warfarin-based models due to the need for frequent blood-level monitoring, drug interactions, dietary considerations, and periprocedural management with warfarin. These models have demonstrated improved anticoagulation control and reduced bleeding complications for patients taking warfarin. Direct oral anticoagulants (DOACs) emerged with the perception of improved convenience due to the lack of blood-level monitoring and lack of dietary considerations. Despite the advantages of DOAC therapy, new challenges exist with their management, warranting ongoing monitoring. Such challenges include prescribing and dosing issues, drug adherence, drug interactions, and high drug cost. Comprehensive anticoagulation centers are needed to manage and monitor all oral anticoagulants including DOACs. The objectives of this review are to describe the challenges and opportunities that exist in the management of DOACs and to describe a practice model that integrates a DOAC management service into the traditional anticoagulation clinic.

journal_name

Pharmacotherapy

journal_title

Pharmacotherapy

authors

Mohammad I,Korkis B,Garwood CL

doi

10.1002/phar.1991

subject

Has Abstract

pub_date

2017-10-01 00:00:00

pages

1284-1297

issue

10

eissn

0277-0008

issn

1875-9114

journal_volume

37

pub_type

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