Safe and effective anticoagulation use: Case studies in anticoagulation stewardship

J Thromb Haemost. 2024 Dec 10:S1538-7836(24)00714-1. doi: 10.1016/j.jtha.2024.11.024. Online ahead of print.

Abstract

Anticoagulant use is prevalent and associated with significant potential for harm. Anticoagulation stewardship practice has emerged to address care gaps and promote safe, effective, and cost-conscious anticoagulation use across health care systems. Here we present 4 patient cases describing common challenges in anticoagulation management: inappropriate dosing of direct oral anticoagulants (DOACs), the diagnosis and management of heparin-induced thrombocytopenia (HIT), periprocedural anticoagulation management, and heavy menstrual bleeding on anticoagulation. We discuss available examples of successful stewardship programs that can address the challenges of each case, demonstrating how an investment in anticoagulation stewardship can improve patient outcomes.

Keywords: anticoagulation; anticoagulation bridge; atrial fibrillation; heavy menstrual bleeding; ischemic stroke; thrombosis.

Publication types

  • Review