Assessment of Population-Based Approach to Direct Oral Anticoagulant Management

Area of Science:

• Pharmacology
• Health Informatics
• Patient Safety

Background:

• The increasing use of direct oral anticoagulants (DOACs) necessitates updated care models.
• A DOAC Dashboard was implemented in an academic medical center to monitor patients on these medications.
• This dashboard tracks patients requiring evaluations for dose or therapy adjustments based on clinical factors.

Purpose of the Study:

• To describe the initial implementation of the DOAC Dashboard.
• To evaluate the effectiveness of interventions triggered by the dashboard.
• To assess a multidisciplinary approach to managing patients on DOACs.

Main Methods:

• A retrospective descriptive study was conducted from August 2019 to January 2022.
• The DOAC Dashboard, integrated into the electronic health record, was used to identify patients.
• Primary outcomes included the number of alerts addressed and interventions required; a secondary outcome was the implementation rate of interventions.

Main Results:

• The DOAC Dashboard identified 10,912 patients at baseline, generating 5,038 alerts.
• Pharmacists addressed 1,796 alerts, including critical alerts for drug-drug interactions and inappropriate dosing.
• Of critical alerts requiring intervention, 88% were implemented by prescribing clinicians.

Conclusions:

• The DOAC Dashboard is an effective tool for identifying patients needing DOAC dose or therapy modifications.
• This system supports proactive management of direct oral anticoagulant therapy.
• The dashboard facilitates a more efficient and safer approach to anticoagulation management.