Anticoagulation therapy is well established, but it can be challenging to provide the optimal solution for long term patient management. Anti-coagulation services, when delivered to a high standard, can provide improved outcomes and lead to reduced costs. But there are different pathway options available for patients on anticoagulation therapy and choosing the best case pathway to deliver optimal support and management can be a challenge. Direct oral anticoagulants (DOACs) with less drug interactions, fixed dosing and no need for routine coagulation monitoring continue to rise in uptake. However, the shift to DOACs poses new challenges for clinicians.

LumiraDx Care Solutions consulted key opinion leaders on the anticoagulation and Atrial Fibrillation fields on how these challenges might be solved. Insights have been collated into Exploring emerging issues in anticoagulation therapy, a collaborative discussion paper that examines:

  • Unanswered questions about the future of anticoagulation
  • Best practice, adherence and education and patient choice for DOACs
  • What affects adherence for patients on long-term therapies
  • Innovative approaches taking place to support excellent anticoagulation service
  • 3

    months NICE recommends patients on DOACs should be reviewed 1
  • 50%

    of patients that should be treated with anticoagulant and are not 2
  • 6

    months it takes for 1 in 3 patients on DOACs to become non-persistent 3
  • 10,000

    fewer strokes per year if NICE Clinical Guideline CG180 were implemented in all people with atrial fibrillation 2
  1. National Institute for Heath and Care Excellence. ‘Anticoagulation – oral, Scenario: Edoxaban.’ Last revised: December 2016. Last accessed: 12 September 2017. https://cks.nice.org.uk/anticoagulation-oral#!scenario:2
  2. Association of the British Pharmaceutical Industry, Stroke in Atrial Fibrillation Initiative. ‘One year on – Why are patients still having unnecessary AF-related strokes?’ April 2016
  3. Xiaxi, Y. et al., 2016. JAHA 115, 003074.

 

Requirements for self-managed care of anticoagulation therapy are different depending on the country, and this may not be available in your country.

NICE recommends patients on DOACs should be reviewed every 3 months