Anticoagulants are a high risk group of medicines and ensuring that patients have sufficient knowledge and understanding to take their medicines properly is a priority for healthcare professionals.
Supporting transition of these patients safely and seamlessly across the boundaries between CCG and secondary care is essential. Both NICE AF guidance and NICE Medicine Optimisation guidelines encourage truly joint decision-making between prescriber and patient when anticoagulants are started, supported by comprehensive counselling to ensure patients understand their medicines and what to do if something goes wrong.
Through a robust, concordant prescribing process with anticoagulants, we ensure beneficence in prescribing and this supports adherence.
Through a robust, concordant prescribing process with anticoagulants, we ensure beneficence in prescribing and this supports adherence. Without this in place, from the start of the patient journey through to the support of long-term care in the community, the process is less efficient and patients can come to harm. Historically, anticoagulation was principally with warfarin which could not be administered without close supervision due to variable pharmacodynamics. The direct oral anticoagulants bring many benefits to patients including pharmacodynamic stability. The disadvantage can be a perception that these agents do not represent a significant bleeding risk and that counselling/monitoring is unnecessary, when in fact there is still a bleeding risk and, therefore, counselling and monitoring remains essential with written materials to support verbal discussions, routine follow up plans and an annual review as a minimum.
In the resources section, you will find a document from the London Stroke Clinical Network called Promoting Adherence During Anticoagulant Therapy which provides a road map of the different points in which adherence support can be provided throughout a patient’s journey.
Here is a road map of the different points that adherence support can be provided during a patient’s Adherence to journey following ... read more