Category: Federal Forum Posters
Purpose: Literature suggests that approximately 8.3 percent of medication errors from the hospital and primary care settings are caused from anticoagulation agents. With the approval of novel, direct oral anticoagulants, anticoagulation management has been transformed in both stroke prevention and venous thromboembolism prophylaxis and treatment. Despite evidence based dosing guidance there has been large variation in prescribing practices that may lead to negative outcomes. The purpose of this study is to determine appropriate use of direct oral anticoagulation therapy through a drug consult review process and population based management tool at Tennessee Valley Healthcare System.
Methods: This multi-site, single center, retrospective cohort study will be submitted to the Institutional Review Board for approval. Part one will assess a change in the drug consult review process transitioning from a generalized process to a specialized process. Patients who were prescribed initial direct oral anticoagulation therapy from October 15, 2017 to October 15, 2018 will be identified through data warehouse extraction. A manual chart review will be conducted for data points including: anticoagulation indication, DOAC dose, serum creatinine, weight, age, consult approval or denial, and reasons for denial. In part two, patients followed by the population based management tool from January 1, 2018 to September 30, 2018 will be identified through data warehouse extraction. A manual chart review will be conducted for data points including: flag category, intervention made, and interventions accepted. Patients in both arms of the study will be excluded if the duration of DOAC therapy is less than 20 days, if a complete manual chart review is unable to be attained, or if DOAC therapy is prescribed by an outsider provider. All patient data will be placed in a password-protected document on a restricted internal drive of the Veterans Health Administration system.
Results: Not applicable
Conclusion: Not applicable
Haley Henry– PGY1 Pharmacy Practice Resident, Tennessee Valley Heatlhcare System, White House, TN