Outpatient oral anticoagulation: guidelines for long-term management

The experience with outpatient anticoagulation services (ACSs) in two municipal teaching hospitals has been reviewed. These two ACSs have provided therapy with a major hemorrhagic morbidity of 4.1% based on patient treatment years and with no anticoagulation-related mortality. Their major goal has been to provide safe, efficient monitoring of anticoagulation control for the patients of a wide variety of primary care physicians in the hospital clinics. With careful patient selection and education, monitoring of the duration of therapy, and close communication among patient, primary care physician, and pharmacist, this goal has been achieved.