While Direct Oral Anticoagulants (DOACs) offer ease of use to patients, stopping bleeding events in patients on DOACs is more complicated, requiring different strategies than those for patients on warfarin (Coumadin®) and heparin. Unlike the more widely available reversal agents for warfarin and heparin, reversal agents for DOACs are lesser known and may not be available in every care setting.
Anticoagulants are the number two top medication involved in adverse drug events leading to death or serious harm. Risks to patients on DOACs can be avoided with timely and appropriate treatment. There are 10 ways to be prepared to treat patients who are on DOACs, and all of them are included in the Sentinel Alert. A few examples include:
- It’s important to understand that you cannot stop the bleeding of patients on DOACs in the same way you can for patients on warfarin and heparin. Reversal agents for DOACs are not as well-known as those for warfarin and heparin and may not be available in all settings.
- Avoid therapeutic duplication, as this is a risk since often providers are not as aware of this class of medications. Also, patients are less likely to recognize these drugs and may not realize they are anticoagulants.
- Educate patients and families about DOACs. Help patients understand their medication schedule, as well as potential for adverse drug reactions and ways to prevent them.
For a list of the DOACs and more ways to be prepared to treat patients on DOACs, see the Joint Commission Sentinel Alert.