Category: Federal Forum Posters
Purpose: With the introduction of direct oral anticoagulants (DOACs), pharmacists have been working to switch patients from warfarin to DOACs when appropriate. The anticoagulation clinic has approximately 1100 patients with 782 receiving a DOAC. Every patient receiving a DOAC is actively monitored in the anticoagulation clinic with an initial appointment, one and three month follow-up, and then every 6 months. With such a large population of patients on DOACs, the workload has become cumbersome. This project aims to establish a process within the anticoagulation clinic to improve efficiency and interventions through utilization of the DOAC dashboard.
Methods: The DOAC dashboard is an electronic table that is refreshed daily and specifically monitors patients receiving DOACs. When critical information such as declining hemoglobin, drug interactions, or patient due for refills meets criteria for an intervention, a flag is noted on the dashboard to alert the user. The initial phase of implementation involves pharmacists prioritizing patients at high risk for adverse events and focusing on critical flags like drug interactions, appropriate dosing, and abnormal labs. Additional flags such as patient due for labs, refills or prescription renewal, and concurrent NSAIDs can be added to the monitoring parameters as the dashboard gains efficiency. When a flag requires attention, the pharmacist will document the problem and provide a recommendation to the provider for management using a note template. The process of new admissions to the anticoagulation clinic for DOAC management will remain unchanged. Patients will have an initial appointment, one month, and three month follow-up with labs. After the three month follow-up, the anticoagulation clinic will continue to monitor the patient for flagged complications through the DOAC dashboard. Finally, pharmacy will provide education to the primary care teams to outline how the dashboard works, pharmacy’s responsibilities, and the primary care teams’ responsibilities.
Results: To be determined
Conclusion: To be determined
Spencer Kurtz– PGY1 Resident, VA Black Hills Health Care System, Sturgis, SD