Direct oral anticoagulants in the hospitalized patient
Topic of Interest
Other
Abstract
The FDA approval of dabigatran in 2010 led a revolution in the practice of anticoagulation management. Whether the classification is called target specific oral anticoagulant, novel oral anticoagulant, or direct oral anticoagulant, these drugs drastically changed the approach to the acute and chronic management to prevent or treat venous thrombotic events. Yet the pharmacokinetics of each of these drugs presents unique challenges to the healthcare provider. The Institute of Safe Medicine Practices labels anticoagulants agents including direct oral anticoagulants and factor Xa inhibitors on the list of the high-alert medication. Furthermore, these drugs are associated with increase risk for readmission and emergency department visits. Effective July 1, 2019, the Joint Commission has added six new anticoagulation elements of performance within the National Patient Safety Goal (NPSG) 3.05.01. These elements of performance reflect the best practices of oral anticoagulation management to ensure patient outcomes.