Annals of African Medicine

REVIEW ARTICLE
Year
: 2020  |  Volume : 19  |  Issue : 3  |  Page : 153--163

Moving towards ideal and appropriate models of anticoagulation management service


Anakwue Raphael 
 Department of Medicine; Department of Pharmacology and Therapeutics, Faculty of Medicine, University of Nigeria Enugu Campus, Dedicated Anticoagulation Clinic, University of Nigeria Teaching Hospital, Enugu, Nigeria

Correspondence Address:
Dr. Anakwue Raphael
Department of Pharmacology/Therapeutics, Faculty of Medical Sciences, University of Nigeria Enugu Campus, Dedicated Anticoagulation Clinic, University of Nigeria Teaching Hospital, Enugu
Nigeria

It is now known that thrombotic disorders such as venous thromboembolism, ischemic stroke, and myocardial infarction contribute significantly to global morbidity and mortality. Anticoagulation service must respond to this new development. Warfarin has continued to provide the backbone for anticoagulation service for decades but with considerable drawbacks. The introduction of nonVitamin K oral anticoagulants (NOACs) has created new challenges. This article seeks to discuss how the establishment of appropriate models of anticoagulation could contain the draw backs of the old anticoagulants and improve on the compliance, availability, affordability, and accessibility of newer anticoagulants. Successful anticoagulation has always been defined by a scientific balancing of the risk of thrombosis and the complication of hemorrhage. To be able to maintain such optimal anticoagulation requires rational drug prescription (physician factor), institutelization of monitoring of therapy (anticoagulation clinic factor) as well as active participation of patients receiving therapy (patient factor). New models of service can be created out of this triad in a bid to replace the old routine medical care model. New models of anticoagulation service should include appropriately trained professionals such as Physicians, Pharmacists, Clinical Pharmacologists, Nurses, and Laboratory Scientists who are knowledgeable in diagnostic, management, and monitoring of anticoagulation. The different models of anticoagulation service discussed in this article clearly demonstrate the need for restructuring of this life saving service particularly in the era of NOAC. Newer models of care that should provide safe, efficacious, and cost-effective services are needed.


How to cite this article:
Raphael A. Moving towards ideal and appropriate models of anticoagulation management service.Ann Afr Med 2020;19:153-163


How to cite this URL:
Raphael A. Moving towards ideal and appropriate models of anticoagulation management service. Ann Afr Med [serial online] 2020 [cited 2020 Sep 18 ];19:153-163
Available from: http://www.annalsafrmed.org/article.asp?issn=1596-3519;year=2020;volume=19;issue=3;spage=153;epage=163;aulast=Raphael;type=0