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Creating an interprofessional guideline to support patients receiving oral anticoagulation therapy: a Delphi exercise

Damen, Nikki L. and Van den Bemt, Bart J. F. and Hersberger, Kurt E. and Papastergiou, John and Alves da Costa, Filipa and Rydant, Silas and Wartenberg, Naomi S. and Lobban, Trudy and Arnet, Isabelle and Antoniou, Sotiris and International Pharmacists for Anticoagulation Care Taskforce, . (2019) Creating an interprofessional guideline to support patients receiving oral anticoagulation therapy: a Delphi exercise. International Journal of Clinical Pharmacy, 41 (4). pp. 1012-1020.

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Official URL: https://edoc.unibas.ch/74492/

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Abstract

Background Oral anticoagulation therapy has proven beneficial impact on the prevention of thromboembolic events. However, the use of antocoagulatns also increases the risk of bleeds. To maximize the benefits and minimize the risks of the treatment, guidance on appropriate use of oral anticoagulants is essential. An international guideline describing relevant components and requirements for pharmaceutical care for patients receiving a therapy woth oral antocoagulants would increase the quality of care. However, recommendations on pharmaceutical care for patients on anticoagulation is lacking. Objective This study aims to develop an interprofessional guideline to support patients in their use of oral anticoagulation therapy. Method Two systematic literature searches were performed on existing guidelines on the management and interventions to improve-oral anticoagulant use, to generate possible recommendations. Subsequently, an international expert panel with 26 pharmacists with extensive experience in clinical and/or scientific work on anticoagulation from a total of 22 European and 4 non-European countries was constituted. With this (geographically well distributed) expert panel, a four-round internet-based Delphi technique was conducted to reach consensus on their relevance. Items were ranked on a 1-10 scale of agreement. A median agreement score of ≥ 7.5 was considered the threshold for consensus. Levels of importance were rated on a 1-3 scale. Setting A global network of 26 pharmacists specialized in oral antocoagulation therapy. Main outcome measure Development of inter-professional guideline. Results After the four Delphi rounds 18 guideline recommendations were formulated. Consensus of opinion was achieved for all recommendations (median agreement: 8.5-10.0), whereas mean levels of importance were between 1.1 and 2.0 (SD: 0.2-0.7). The following domains were rated as most important targets for improving the care around oral anticoagulation: 'INR-monitoring', 'Transfer of care between health care settings', 'Adherence to medication', 'Patient communication and engagement', and 'Medication reconciliation and medication review'. Conclusion The 18 recommendations included in this guideline provide the base for optimization of anticoagulation care across different countries/healthcare systems. Future work involves translating the guideline recommendations into clinical practice. Once implemented, the recommendations of the guideline will support health care providers with the pharmaceutical care for patients on, oral anticoagulation which will improve the effective and safe use of these medicines.
Faculties and Departments:05 Faculty of Science > Departement Pharmazeutische Wissenschaften > Pharmazie > Pharmaceutical Care (Hersberger)
UniBasel Contributors:Arnet, Isabelle and Hersberger, Kurt E.
Item Type:Article, refereed
Article Subtype:Research Article
ISSN:2210-7711
Note:Publication type according to Uni Basel Research Database: Journal article
Identification Number:
Last Modified:21 May 2020 10:09
Deposited On:21 May 2020 10:09

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