Doctors and pharmacists have the opportunity to lower the incidence of incorrect dosing of blood thinners, as well as the associated risks of blood clots and strokes, through the use of an electronic patient management system, according to a recent study.
Research indicates that electronic patient management systems can help doctors and pharmacists minimize the inappropriate dosing of blood thinners, thereby reducing the risk of blood clots and strokes.
Created by the United States Veterans Health Administration in 2016, the online dashboard aims to improve the treatment process for patients prescribed direct oral anticoagulants (DOACs), which are widely used blood thinners.
Researchers from Michigan Medicine evaluated over 120,000 instances of patients diagnosed with either atrial fibrillation or venous thromboembolism, who were treated with DOACs across 123 VA hospitals from mid-2015 to 2019.
The findings revealed that between 6.9% and 8.6% of patients received incorrect blood thinner prescriptions.
By implementing the electronic DOAC management tool, hospitals experienced a reduction in off-label dosing by approximately 8%.
Every hospital that adopted the monitoring tool also saw a drop in both blood clots and stroke rates.
These findings were published in the Journal of the American Heart Association.
Geoffrey Barnes, M.D., M.Sc., the study’s lead author and associate professor of cardiology and internal medicine at U-M Medical School, stated, “While DOACs are crucial for treating common thrombotic issues, inappropriate prescribing can lead to severe consequences.”
“Our study not only reveals the frequency of off-label DOAC prescriptions but also emphasizes that utilizing this management tool can effectively reduce inappropriate dosing and its associated risks, such as strokes and clots,” he added.
It’s noted that DOACs can be incorrectly prescribed up to 20% of the time.
The two most common DOACs are rivaroxaban (branded as Xarelto) and apixaban (branded as Eliquis).
Hospitals that have utilized the system the longest witnessed more notable reductions in inappropriate prescriptions.
In Michigan, the Michigan Anticoagulation Quality Improvement Initiative, which is a collaborative effort among various state hospitals, developed a similar dashboard using the Epicâ„¢ electronic health record system.
Currently, five hospitals in the state, including University of Michigan Health, are implementing this system.
Barnes commented, “This study stands as one of the largest and most significant assessments of anticoagulation stewardship aimed at decreasing negative clinical outcomes.”
“Health systems and policymakers should prioritize investments in anticoagulation stewardship programs that assist pharmacists in reviewing and correcting off-label doses of direct oral anticoagulants, benefiting the millions of patients using these medications.”
