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Safe and effective anticoagulation use: case studies in anticoagulation stewardship
Jori E May1, Arthur L Allen2, Bethany T Samuelson Bannow3
1Department of Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Journal of Thrombosis and Haemostasis : JTH
|December 12, 2024
Summary
Anticoagulation stewardship programs improve patient safety and outcomes by addressing common challenges like incorrect dosing and managing side effects. These programs promote safe, effective, and cost-conscious medication use.
Area of Science:
- Pharmacology
- Internal Medicine
- Patient Safety
Background:
- Anticoagulant medications are widely used but carry a high risk of adverse events.
- Gaps in care and suboptimal medication use necessitate improved management strategies.
- Anticoagulation stewardship has emerged as a critical practice to optimize patient care.
Purpose of the Study:
- To highlight common challenges in anticoagulation management.
- To present case studies illustrating these challenges.
- To demonstrate the benefits of anticoagulation stewardship programs.
Main Methods:
- Review of 4 patient cases with complex anticoagulation management issues.
- Discussion of direct oral anticoagulant dosing errors.
- Exploration of heparin-induced thrombocytopenia diagnosis and management.
- Analysis of periprocedural anticoagulation and anticoagulation for heavy menstrual bleeding.
- Examination of successful anticoagulation stewardship program models.
Main Results:
- Inappropriate dosing of direct oral anticoagulants is a frequent issue.
- Heparin-induced thrombocytopenia requires careful diagnosis and management.
- Periprocedural anticoagulation and managing bleeding risks present significant challenges.
- Successful stewardship programs can effectively address these complex cases.
Conclusions:
- Anticoagulation stewardship is essential for safe and effective medication use.
- Implementing stewardship programs can lead to improved patient outcomes.
- Investment in anticoagulation stewardship optimizes healthcare resource utilization and patient safety.
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