NCT03527615

Clinical Pharmacist Anticoagulant Stewardship

Clinical Pharmacist Led Hospital-Wide Direct Oral Anticoagulant Stewardship Program

• Status: Unknown
• Phase: —
• Study type: Observational
• Enrollment: 4,000 (estimated)
• Sponsor: Hadassah Medical Organization · Academic / Other
• Sex: All
• Age: —
• Healthy volunteers: Not accepted

Summary

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

Detailed 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.

Conditions

• Safety Issues
• Anticoagulant Toxicity

Interventions

Type	Name	Description
OTHER	Clinical Pharmacist Medication Review	Programmatic review of physician orders for direct anticoagulants by clinical pharmacists.

Timeline

• Start date: 2017-01-01
• Primary completion: 2020-01-01
• Completion: 2020-01-01
• First posted: 2018-05-17
• Last updated: 2018-05-17

Locations

1 site across 1 country: Israel