Perfect: Selecting the correct regimen (2)
Perhaps the commonest scenario is where a patient has had a coronary intervention with a stent to the coronary artery, where a period of combined therapy (dual antiplatelet plus anticoagulation followed by a period of single antiplatelet plus anticoagulation) may be prescribed.
Providing written and verbal information to the patient and/or carer is important to support adherence to treatment and to ensure that any adverse effects are identified and acted on. Figure 1 above highlights the key points to consider for a patient consultation regarding anticoagulation with a DOAC for AF.
Much of this is the same for warfarin – although for warfarin additional advice on when and where the INR should be checked, how the dose is adjusted and diet/alcohol interactions will need to be included.
Reflection exercise 2
Ensuring a patient with AF is well controlled and receiving appropriate anticoagulation will reduce the morbidity and mortality associated with the condition. Consider how your community pharmacy team could increase public awareness of atrial fibrillation and why anticoagulation is important to reduce the risk of stroke in patients with the disease.