Using Detective Skills: Getting to the Bottom of Dual Antiplatelet Therapy

Consultant pharmacists have always been effective at identifying patients at high risk for bleeding. Their training qualifies them to do more than just identify. Early in the author's career, he was trained to look for dual antiplatelet therapy (DAPT) and recommend monitoring for signs and symptoms of bleeding in those identified. He used this method for several months before a nurse called him out and asked, "Why do you send us recommendations to monitor for bleeding?" She explained that this was a routine part of nursing assessments, regardless of the presence of DAPT. That's when he realized that the recommendation was like telling a pharmacist not to crush an extended-release formulation of a medication. It was duplicating the work of other health care professionals, undervaluing their expertise, and counterproductive to a team-based approach.