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DOAC screening service reduces dosing errors, improves medication access

16 May 2020

Implementing a direct oral anticoagulation (DOAC) screening service at a large academic medical centre provides patient education and results in improved medication access, improved follow-up, and the identification and resolution of dosing errors, according to a study.

A pharmacist-led antithrombosis clinic started a clinical service to provide oversight for all prescribed DOACs. This was done by using a daily electronic prescribing report of DOAC prescriptions. Clinical pharmacists then reviewed prescriptions to assess patient insurance, eligibility and accuracy of prescribed doses.

In total, 317 new prescriptions and 595 refill prescriptions were reviewed in the first year since service implementation in April 2016. A DOAC service pharmacist contacted 125 (39.4 percent) of 317 patients regarding their new prescription and 59 (9.9 percent) of 595 refill patients to provide education and follow-up on management as needed. Seventy-nine (28 percent) new prescriptions and 86 (14.5 percent) refill prescriptions received interventions.

For the new prescriptions, common interventions performed were contacting the prescriber for a medication or dose change (25.4 percent), assistance with medication access (21.5 percent), and coordinating appropriate lab and provider follow-up (21.5 percent). Common interventions with refill prescriptions included recommending appropriate follow-up (50 percent) and contacting the prescriber for medication or dosage change (24.4 percent).

These findings were consistent with those of a 2017 study which reported that a pharmacist-led DOAC service increased appropriate dosing of DOACs at baseline and follow-up as well as patient adherence to therapy. [Am J Health Syst Pharm 2017;74:483-489]

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Most Read Articles
6 days ago
Chest pain appears to be the principal complaint of patients hospitalized with a first myocardial infarction (MI), particularly among those in the youngest age group, a study has found.
Jairia Dela Cruz, 16 Sep 2020
In patients with heart failure with reduced ejection fraction (HFrEF) receiving angiotensin-converting-enzyme (ACE) inhibitors, high dosing confers benefits for the risk of death or hospitalization that are similar to that obtained with lower dosing, according to a systematic review and meta-analysis.
Pearl Toh, 6 days ago
Early and sustained treatments with simplified regimen are the key to achieving good asthma control, said experts during a presentation at the ERS 2020 Congress.
20 Sep 2020
Women with pre-eclampsia are at higher risk of developing heart failure, a study suggests.