Clinical Pharmacist Anticoagulant Stewardship

H

Hadassah Medical Center

Status

Unknown

Conditions

Anticoagulant Toxicity
Safety Issues

Treatments

Other: Clinical Pharmacist Medication Review

Study type

Observational

Funder types

Other

Identifiers

NCT03527615
DOACPHARM-HMO-CTIL

Details and patient eligibility

About

Initiative to improve direct anticoagulant utilization involving programmatic review by clinical pharmacists in collaboration with multidisciplinary team.

Full description

The Hadassah Hebrew University Medical Centers' Clinical Pharmacy team initiated a hospital-wide program, in collaboration with the institutions' coagulation specialists, including two hematologists and a clinical pharmacologist, for monitoring and promoting safe and effective prescription of direct oral anticoagulants (DOAC) during hospitalization. Electronic medical records throughout the hospital are screened for DOAC orders. All DOAC orders are assessed by a clinical pharmacist for potentially-inappropriate prescribing. When potentially-inappropriate prescribing or a drug-related problem is identified, the clinical pharmacist provided consultation on management options. In specific cases, additional guidance is provided by coagulation specialists. Consultations are recorded in the electronic medical record. Performance measures are collected and summarized.

Enrollment

4,000 estimated patients

Sex

All

Volunteers

No Healthy Volunteers

Inclusion criteria

Patients hospitalized in Hadassah Medical Center with a physician's order for direct oral anticoagulants (apixaban, rivaroxaban, or dabigatran).

Exclusion criteria

Patients hospitalized in departments without computerized physician order entry.

Trial contacts and locations

1

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Central trial contact

Amichai Perlman, Pharmd

Data sourced from clinicaltrials.gov

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