Our practice clinical pharmacist Peter Magennis has over-all responsibility for the
administration, audit and managing the anti-coagulation clinic. He runs the
anticoagulation clinic twice a week; on a Monday and Wednesday.
He is supported by the practice's advanced nurse practitioner (ANP) Jo Courtenay. Together they ensure there is cover for sickness and holiday periods. Patient testing and dosing is carried out with a POC (point of care) machine using a simple finger prick which is less invasive than standard venous sampling. The additional benefit of this is that we are also able to provide instant interpretation of the results and dose adjustment.
If you are a patient of Morris House and have your monitoring performed elsewhere (such as a hospital) you may find it more convenient to attend the practice for your care. Additionally, if your current GP practice does not offer warfarin management we may be able to do it for you so you do not need to attend the hospital.
Direct oral anticoagulants (DOACs)
There are four DOACs available in the UK. Each has its own specific indications and dosing information.
Monitoring for patients on these newer medicines is less time consuming for both patients and practices.
Periodic review is necessary to check renal and liver functions which affect the way these medicines are metabolised. It is also necessary to assess compliance and check for adverse effects such as bleeding. However, the anticoagulant effect is not monitored in the same way as warfarin.
The correct dose must be prescribed. This depends on factors such as age, weight, renal function and clinical indication. It is important that the correct calculation is used for renal function and recorded in the patient record.
We also will initiate, prescribe and monitor these medicines in the practice. Not everyone who is prescribed warfarin can be moved to a DOAC. The more commonly used indications for DOACs are non-valvular atrial fibrillation or venous thromboembolism.