Related Experiment Video

Updated: Jun 7, 2026

Direct Drug Delivery to Kidney via the Renal Artery
11:18

Direct Drug Delivery to Kidney via the Renal Artery

Published on: April 17, 2021

Access to renal function information to improve pharmaceutical care in direct oral anticoagulant users: a cluster

Imane Badran1, Justine Clarenne1, Céline Mongaret2

  • 1Department of Clinical Pharmacy, Université de Reims Champagne-Ardenne, GRAPP, F-51100, Reims, France.

BMC Primary Care
|June 5, 2026
PubMed

Insights

Providing community pharmacists with patient renal function data can help optimize direct oral anticoagulant (DOAC) selection and dosage, potentially reducing bleeding risks. This study investigates the impact of this access on bleeding events in DOAC users.

Area of Science:

  • Pharmacology and Pharmaceutical Sciences
  • Clinical Pharmacy Practice
  • Patient Safety and Risk Management

Background:

  • Direct oral anticoagulants (DOACs) are crucial for thromboembolic disease management but increase bleeding risk.
  • Renal impairment is a significant risk factor for bleeding in DOAC users.
  • Community pharmacists often lack access to essential patient renal function data for safe DOAC dispensing.

Purpose of the Study:

  • To evaluate the clinical impact of granting community pharmacists systematic access to patients' renal function information.
  • To assess if this access optimizes DOAC choice and dosage, thereby reducing bleeding events.
  • To determine the feasibility of integrating renal function data access into community pharmacy workflows.

Main Methods:

  • A prospective, randomized, cluster, multicenter trial involving 96 community pharmacies.
  • 1920 patients will be randomized into an intervention group (access to renal function) and a control group (usual care).
  • The primary endpoint is the occurrence of clinically relevant bleeding (major and nonmajor) within three months post-DOAC dispensing.

Main Results:

  • This section is to be filled after the study is completed.

Conclusions:

  • The study will provide crucial insights into the clinical utility of providing renal function data to community pharmacists.
  • Findings may inform best practices for ambulatory pharmaceutical care and enhance patient safety in DOAC therapy.
  • The results have the potential to drive significant improvements in medication management and reduce preventable bleeding complications.
Abstract

Keywords:
Bleeding eventsCommunity pharmacistsDirect oral anticoagulantsPharmaceutical careRenal function

More Related Videos

Rapid Point-of-Care Assay of Enoxaparin Anticoagulant Efficacy in Whole Blood11:17

Rapid Point-of-Care Assay of Enoxaparin Anticoagulant Efficacy in Whole Blood

Published on: October 12, 2012

Related Concept Videos

Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants01:18

Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants

Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Factors Affecting Renal Clearance: Renal Impairment01:17

Factors Affecting Renal Clearance: Renal Impairment

Renal dysfunction significantly impairs the renal clearance of drugs, leading to potential complications in drug therapy. Renal failure, which can be caused by various factors, poses a significant challenge in the elimination of drugs from the body.
One condition associated with renal failure is uremia. Uremia is characterized by impaired glomerular filtration and fluid accumulation in the body. This condition hinders the renal clearance of drugs, resulting in drug accumulation and potential...
Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant01:25

Drug Dosing in Renal Diseases: Dose Adjustments Based on Drug Clearance and Elimination Rate Constant

In patients with renal disease, dosage adjustments are necessary to maintain therapeutic plasma drug concentrations and prevent toxicity or subtherapeutic exposure. Renal impairment alters drug pharmacokinetics, especially in conditions like uremia, where changes such as prolonged elimination half-life and altered apparent volume of distribution can significantly affect drug disposition. These changes require careful modification of the dosing regimen to achieve the desired clinical...
Drug Dosing in Renal Diseases: Measurement of Serum Creatinine Concentration and Clearance01:25

Drug Dosing in Renal Diseases: Measurement of Serum Creatinine Concentration and Clearance

In healthy individuals, serum creatinine levels remain stable due to a balance between its constant production—primarily from muscle metabolism—and renal excretion. Creatinine is freely filtered by the glomeruli, making it a valuable marker for estimating renal function. When the glomerular filtration rate (GFR) decreases, the kidneys can only eliminate less creatinine, causing serum levels to rise.Serum creatinine concentration is widely used to estimate creatinine clearance (Clcr), a...
Acute Kidney Injury IV: Diagnostic Studies and Prevention01:30

Acute Kidney Injury IV: Diagnostic Studies and Prevention

Accurate diagnosis and effective prevention are critical in managing Acute Kidney Injury (AKI), which is linked to high mortality rates ranging from 10% to 80%. Timely recognition of at-risk patients and careful monitoring can significantly reduce the likelihood of kidney damage.Diagnostic Assessments:The diagnostic process starts with a comprehensive medical history to identify prerenal, intrarenal, and postrenal causes.Prerenal causes, such as dehydration, hypotension, or blood loss, should...
Antihypertensive Drugs: Direct Renin Inhibitors01:25

Antihypertensive Drugs: Direct Renin Inhibitors

The renin-angiotensin-aldosterone system (RAAS) is an intricate physiological pathway involving numerous enzymes and hormones, including renin, angiotensin-converting enzyme (ACE), angiotensin I and II, and aldosterone. Imbalances within this system increase the production of angiotensin II and aldosterone. Increased angiotensin II levels promote vasoconstriction and blood pressure elevation. Concurrently, higher aldosterone levels stimulate sodium and water reabsorption in the kidneys,...