Incorporating Comprehensive Management of Direct Oral Anticoagulants into Anticoagulation Clinics
| Autor: | Insaf Mohammad, Bianca Korkis, Candice L. Garwood |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
medicine.drug_class Anticoagulation management Administration Oral Hemorrhage 030204 cardiovascular system & hematology Ambulatory Care Facilities 03 medical and health sciences 0302 clinical medicine medicine Humans Pharmacology (medical) Drug Dosage Calculations Drug Interactions 030212 general & internal medicine Dosing International Normalized Ratio Intensive care medicine Blood Coagulation business.industry Drug cost Warfarin Anticoagulants Vitamin K antagonist Drug adherence Models Organizational Practice Guidelines as Topic Drug Monitoring Anticoagulation clinic business medicine.drug |
| Zdroj: | Pharmacotherapy. 37(10) |
| ISSN: | 1875-9114 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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