Pharmacist Role in Anticoagulant Adherence

Pharmacists can play an important role in keeping patients with atrial fibrillation adherent to anticoagulants, says Sarah Spinler, PharmD, professor of clinical pharmacy at Philadelphia College of Pharmacy.

Adherence to anticoagulant therapy is important when considering that a missed dose could mean a lack of protection from thromboembolism, Dr. Spinler notes. It is especially vital for the new oral anticoagulants (NOACs), even more so than warfarin.

Pharmacists can monitor adherence during transitions of care from the hospital to outpatient treatment by tracking whether the patient tolerates the prescribed anticoagulant and can afford the medication.

Some others ways in which pharmacists can help atrial fibrillation patients stay adherent are refill reminders and patient education.

For example, pharmacists can remind patients not to use a pillbox if they take dabigatran, which should not be exposed to air. Pharmacists can also ask patients with NOAC prescriptions if they know why they are taking that treatment. If they do not know, then this presents an opportunity for patient education.

Both patients and caregivers should know what atrial fibrillation is, what the risk of stroke is, and why anticoagulation is important, Dr. Spinler says.

Pharmacists can also look at concomitant drug use to determine whether the patient needs to continue taking medications like aspirin or antidepressants.