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Creating an interprofessional guideline to support patients receiving oral anticoagulation therapy: a Delphi exercise
JournalArticle (Originalarbeit in einer wissenschaftlichen Zeitschrift)
ID 4514425
Author(s) Damen, Nikki L.; Van den Bemt, Bart J. F.; Hersberger, Kurt E.; Papastergiou, John; Alves da Costa, Filipa; Rydant, Silas; Wartenberg, Naomi S.; Lobban, Trudy; Arnet, Isabelle; Antoniou, Sotiris; International Pharmacists for Anticoagulation Care Taskforce,
Author(s) at UniBasel Arnet, Isabelle
Hersberger, Kurt
Year 2019
Title Creating an interprofessional guideline to support patients receiving oral anticoagulation therapy: a Delphi exercise
Journal International Journal of Clinical Pharmacy
Volume 41
Number 4
Pages / Article-Number 1012-1020
Keywords Guideline development; Interprofessional guideline; Oral anticoagulations; Pharmaceutical care
Mesh terms Administration, Oral; Anticoagulants, therapeutic use; Consensus; Delphi Technique; Guidelines as Topic, standards; Humans; Internationality; Pharmaceutical Services, standards
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.
Publisher SPRINGER
ISSN/ISBN 2210-7711
Full Text on edoc No
Digital Object Identifier DOI 10.1007/s11096-019-00844-0
PubMed ID
ISI-Number WOS:000478769400021
Document type (ISI) Journal Article

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