Taking blood thinners? Healthcare professionals can help monitor usage.

Heart Health
Jul 10, 2018

AnticoagulantClinic_Main

St. Joseph’s/Candler Center for Medication Management offers an anticoagulant monitoring clinic and service line

When used properly, medications can be lifesaving. However, many come with side effects that need to be monitored not just by you but a team of healthcare professionals. One example is blood thinners.

Anticoagulants, also known as blood thinners, reduce or prevent the coagulation (clotting) of blood. This decreases the chances for complications of preexisting blood clots or preventing the formation of new ones, therefore reducing the chances of a stroke.

Ashley Woodhouse, PharmD, BCACP, a clinical pharmacy specialist at the Center for Medication ManagementNot all patients need to be on anticoagulants, says Ashley Woodhouse, PharmD, BCACP, a clinical pharmacy specialist at the Center for Medication Management. However, for patients who develop blood clots or who are at high risk of blood clot formation, it may be recommended. In some cases, this may not be something patients have to take the rest of their lives.

Related Article: Who should take blood thinners?

For patients on blood thinners, there is an increased risk of heavy bleeding, even with the slightest of cuts. Because of this risk, as well as the already high risk of strokes, anticoagulants can be harmful if misused. To ensure patients on blood thinners properly use all their medications, St. Joseph’s/Candler Center for Medication Management offers an outpatient anticoagulant monitoring clinic and service line dedicated to keeping patients on blood thinners safe. The clinic was recognized by the Anticoagulation Forum as an Anticoagulation Center of Excellence.

“The reason to come in and see us and be in an anticoagulants program is to prevent having an embolic event or adverse bleeding event,” Woodhouse says. “We are pharmacists and advocates for our patients.”

Nurse practitioners with the anticoagulation clinic help patients monitor their blood thinner use and educate patients on anticoagulants, combining medications and any other questions a patient may have. The number of visits depends on the indication and anticoagulation strategy.

Additionally, clinical pharmacist and nurse practitioners with the Center for Medication Management offer patients time and education not just their current anticoagulant medication but all their medications.

“If they have a question about their blood pressure, we try to answer it. Even if they are referred for one thing, we try to help them with everything whether it’s vaccinations or other medications. If they want to understand something better, we are going to take the time.”

Some examples of conditions that may require blood thinners and anticoagulant monitoring are:

Atrial fibrillation (AFib)

Atrial fibrillation is the most common heart rhythm abnormality. Patients with AFib are at a higher risk of heart attacks or stroke.

Related Article: What causes Atrial Fibrillation? 

The heart normally pumps at a consistent rate and rhythm. When patients are in AFib, typically the left atrium of the heart beats faster and more erratically than normal. Since the heart does not beat at consistent times and at the same strength with each pump, blood can pool in the appendage of the heart causing a clot to form. If a clot forms in the heart, the clot can be released from the heart and travel to the brain causing a stroke.

Anticoagulants decrease the chance that blood clots will form in the heart. Not all patients with a history of AFib will require anticoagulants. Be sure to talk to your doctor about all your options.

Related Article: Understand Atrial Fibrillation and its misconceptions

Deep Vein Thrombosis (DVT)/Pulmonary Embolism (PE)

Deep vein thrombosis is a blood clot that forms in deep veins of the legs. This can block blood flow causing pain, swelling, warmth and redness of your legs. DVTs normally occur in only one leg.

These blood clots can potentially travel through the veins to the lungs. When a clot goes to the lungs, this is a called a pulmonary embolism (PE). The blockage can make it hard to breathe, cause sharp chest pain, coughing or coughing up blood and can be potentially fatal.

Anticoagulants stop the blood clots from becoming larger and prevent new clots from forming. Patients who have these blood clots will usually need to be on anticoagulants for three months or longer. Talk to your physician about all your options.

Heart Valve Replacement

The heart pumps blood through the body in one direction. The heart has four chambers and these are separated by tunnels, or valves. Heart valves may get damaged or become blocked over time. This can cause the blood to build up and cause heart, lung or other problems.

Surgery may be the only way to repair the damaged heart valves. Since some of these valves are foreign materials to the body, blood products may stick to them and start to form clots. Depending on the type of heart valve replacement needed, anticoagulation may be recommended long-term.

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Anticoagulants can be safe if they are monitored appropriately and under the supervision of a healthcare professional.

A physician’s referral is needed for the St. Joseph’s/Candler Center for Medication Management anticoagulation monitoring program. It is covered by Medicaid and Medicare, and most insurance companies cover it after a co-pay. Anticoagulation monitoring is available at all five of our Medication Management locations – Savannah, Skidaway Island, Pooler, Bluffton and Hilton Head.

For more information or to have your physician initiate a referral, call us at 912-819-8407. To learn more about SJ/C Center for Medication Management, visit our website.

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