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Expert coalition provides recommendations to reduce adverse drug events from anticoagulants during care transitions

Added on October 23, 2018 in General News
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Media Contact:
Maureen Lyons
Corporate Communications
(630) 792-5171
mlyons@jointcommission.org

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Article appears in November 2018 issue of The Joint Commission Journal on Quality and Patient Safety

(OAKBROOK TERRACE, Illinois, October 23, 2018) – Anticoagulants, medications that keep the blood from clotting, are heavily prescribed and effective but have been identified as major contributors to adverse drug events (ADEs). Because many serious ADEs are thought to be preventable through improvements in care delivery, proper anticoagulants management is important during the continuum of care across the entire health care system, including during care transitions.
 
A new article in the November 2018 issue of The Joint Commission Journal on Quality and Patient Safety details the work of an IPRO-convened task force of The New York State Anticoagulation Coalition to develop a list of requisite data elements (RDEs) to adequately manage the anticoagulants of patients new to care from a previous setting.
 
The article, “Defining Minimum Necessary Anticoagulation-Related Communication at Discharge: Consensus of the Care Transitions Task Force of the New York State Anticoagulation Coalition,” by Darren Triller, PharmD, president and CEO, WellScriptEd Consulting, Inc., Delmar, New York, and co-authors, outlines 15 RDEs on which the task force reached consensus for anticoagulation communication at discharge (the ACDC List):
  • Anticoagulant(s) currently used
  • Indication(s) for anticoagulation therapy
  • Documentation describing whether the patient is new to anticoagulation therapy or a previous user
  • If a patient is new to anticoagulation therapy, the start date of the anticoagulation
  • Documentation indicating whether treatment is intended to be acute (short term) or chronic (long term)
  • If any acute indications, the intended duration of therapy
  • Date, time, route, dose and strength of last two doses given
  • Date, time and magnitude of next dose due
  • Most recent assessment of renal function (within past 30 days, with date and results)
  • Documentation of the provision of patient education materials about the anticoagulant
  • Assessment of patient/caregiver understanding of their anticoagulant regimen
  • If transitioning to a non-institutionalized setting, expectations for who was responsible for ongoing anticoagulation management
  • If prescribed warfarin, the target International Normalized Ratio (INR) or INR range
  • If prescribed warfarin, a minimum of 2–3 consecutive INR lab results (with dates and results)
  • If prescribed warfarin, the date the next INR is due
“Effective solutions to improve anticoagulation safety and effectiveness will be complex, but the ACDC List is an important contribution to improving anticoagulation management during one of the most vulnerable periods of patient care,” notes Nadine Shehab, PharmD, MPH, senior scientist, Medication Safety Program, Division of Healthcare Quality Promotion, Centers for Disease Control and Prevention, Atlanta, and co-authors, in an accompanying editorial. The authors recommend additional research to validate the ACDC and evaluate the impact of related interventions on patient outcomes.
 
Also featured in the November 2018 issue:

For more information, visit The Joint Commission Journal on Quality and Patient Safety website. 

 
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Note for editors
The article is “Defining Minimum Necessary Anticoagulation-Related Communication at Discharge: Consensus of the Care Transitions Task Force of the New York State Anticoagulation Coalition,” by Darren Triller, PharmD; Anne Myrka, BS Pharm, MAT; John Gassler, MD; Kelly Rudd, PharmD, FCCP, BCPS, CACP; Patrick Meek, PharmD, MS; Peter Kouides, MD; Allison E. Burnett, PharmD, PhC, CACP; Alex C Spyropoulos, MD, FACP, FCCP, FRCPC; and Jack Ansell, MD, MACP. The article appears in The Joint Commission Journal on Quality and Patient Safety, volume 44, number 11 (November 2018), published by Elsevier.
 
The editorial is “Anticoagulation Across Care Transitions: Identifying Minimum Data to Maximize Drug Safety,” by Nadine Shehab, PharmD, MPH; Jeffrey L. Greenwald, MD; and Daniel S. Budnitz, MD, MPH. The article appears in The Joint Commission Journal on Quality and Patient Safety, volume 44, number 11 (November 2018), published by Elsevier.
 
The Joint Commission Journal on Quality and Patient Safety
The Joint Commission Journal on Quality and Patient Safety (JQPS) is a peer-reviewed journal providing health care professionals with innovative thinking, strategies and practices in improving quality and safety in health care. JQPS is the official journal of The Joint Commission and Joint Commission Resources, Inc. Original case studies, program or project reports, reports of new methodologies or the new application of methodologies, research studies, and commentaries on issues and practices are all considered.
 

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