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Anticoagulation Stewardship Efforts Via Indication Reviews at a Veterans Affairs Health Care System

Alexandra Brown1, Annie Tam1

  • 1Veterans Affairs Phoenix Health Care System, Arizona.

Federal Practitioner : for the Health Care Professionals of the VA, Dod, and PHS
|March 26, 2026
PubMed

Insights

Pharmacist-led anticoagulation stewardship identified gaps in care for veterans with atrial fibrillation (Afib) and venous thromboembolism (VTE). Interventions aimed to optimize anticoagulant therapy, ensuring safe and effective treatment for this population.

Area of Science:

  • Pharmacology
  • Quality Improvement
  • Health Systems Pharmacy

Background:

  • Anticoagulation is crucial for preventing thrombotic events in atrial fibrillation (Afib) and venous thromboembolism (VTE).
  • Inappropriate anticoagulant use can lead to adverse drug events.
  • Pharmacist-led anticoagulation stewardship was implemented at VAPHCS to address these issues.

Purpose of the Study:

  • To identify patients with Afib not on anticoagulation.
  • To identify patients with VTE who completed sufficient treatment.
  • To optimize anticoagulant therapy in the veteran population.

Main Methods:

  • Chart review of veterans with Afib or VTE.
  • Standardized note template for documenting recommendations.
  • Identification of veterans with VTE on anticoagulation for November 2022-November 2023.

Main Results:

  • 114 patients included (57 Afib, 57 VTE).
  • 7 recommendations made for Afib patients; 1 veteran started anticoagulation.
  • 7 recommendations made for VTE patients.

Conclusions:

  • Quality improvement study identified gaps in anticoagulation care for veterans.
  • Standardized review process enables pharmacists to assess indication and duration.
  • Recommendations via chart notes can optimize veteran anticoagulation care.
Abstract

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