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News & Presentations for todays Optimising Anticoagulation Therapy conference

Components of an excellent anticoagulation service
Joanne Smithson,
Digital Health Programme Lead, Academic Health Science Network for the North East and North Cumbria
Pre-event abstract
The Academic Health Science Network for the North East and North Cumbria is working with Newcastle Gateshead CCG and the Newcastle upon Tyne Hospitals NHS Foundation Trust to optimise the entire AF anticoagulation pathway in the Newcastle area.
The programme of work aims to improve patient treatment, stratification and personalisation of care.  At the heart of the optimised pathway are three innovations: warfarin sensitivity genotype testing before choice of anticoagulant is made, then where appropriate, genotype guided warfarin initiation, and subsequently an option for patients to self-test their INR at home.
Qualitative findings from the programme are presented alongside a discussion of the challenges of implementing change projects across a health system.  The presentation explores what an excellent anticoagulation service looks like in practice, focusing on the delivery of patient INR self-testing in partnership with Inhealthcare and 4S Dawn.
The project has been funded by the national group of Academic Health Science Networks, Pfizer, and Bristol-Myers Squibb.
Joanne, speaking this morning said:
"What is delivering an excellent Service?"
"At the heart of our work is a Personalised Patient Centred Approach – making sure all the information is given and empowering the patient" 
She also explained about self-testing and how the service works, and how INR Self Testing is carried out with In Healthcare and 4S Dawn.
Full PowerPoint Presentation

Warfarin and DOAC monitoring
Bunis Packham,
Chair, Anticoagulation Specialist Association, Nurse Consultant Thrombosis & Anticoagulation, Royal Free London NHS Foundation Trust
Pre-event abstract
Anticoagulants have been identified as one of the five high risk medicine, therefore it is important for us to ensure patients who take anticoagulants adhere to the treatment and work in partnership with us
Management of anticoagulant therapy by medical and non-medical health professionals is viewed professionally and legally as an advanced area of clinical practice. Only a trained competent health professional should undertake the assessment, consultation, and titration and prescribe treatment for patients. This can be achieved by ensuring standardized training and systematic assessment are in place. It is clearly highlighted in the literature the importance of protocol, patient group direction and guidelines for it is a way to promote evidence- based practice, which is placed within clinical governance. It is estimated that approximately one in ten patients experience unnecessary harm or suffering due to mistakes that happen in hospitals. 50% of these errors could be avoided if the lessons from previous mistakes have been learned
NPSA has defined high risk medicines as medicines that are most likely to cause significant harm to the patient, even when used as intended. The Institute for Safe Medication Practices reports that incident rates with this group of medicines may not necessarily be higher than with other medicines, but when incident occur the impact on the patient can be significant.
Full PowerPoint Presentation


Complex anticoagulation issues: Anticoagulation in the frail, restarting anticoagulation after a bleed, oral anticoagulants combined with anti-platelet drugs
Dr Clifford Lisk,
Consultant Physician in Acute Medicine and Geriatric Medicine, Barnet Hospital, Royal Free Hospitals NHS Foundation Trust
Pre event abstract 
Anticoagulation in the elderly has been revolutionized by the introduction and use of NOACS. This practical talk aims to update the audience about anticoagulation choices in older age, the evidence base for NOACS in older adults, whats unique about older adults and should be considered by clinicians when prescribing, dosing in specific situations, antiplatelet and anticoagulation use in patients with AF and Coronary artery disease, bleeding complications and current reversal agents. He will also focus on the selection of appropriate NOACS when managing high risk patients drawing on real world experiences from his clinical practice and touch upon when to consider deprescribing in frail older persons.
Full PowerPoint Presentation 


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