DOAC support programme. engage supported self-care

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Spencer Elliott
5 years ago
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1 DOAC support programme engage supported self-care

2 changes in anticoagulation therapy Managing patients receiving anticoagulation (AC) therapy effectively and consistently can be challenging. Direct oral anticoagulants (DOACs) are increasingly popular, with fewer drug interactions, fixed dosing and no need for routine coagulation monitoring. We asked our INRstar users to tell us what challenges they experience managing patients on DOACs. They told us the most common challenges are: 1 Making sure patients are regularly reviewed Managing patients forgetting or missing doses (tablet adherence) Ensuring annual blood tests are done addressing these challenges The EHRA and NICE recommend that patients on DOACs receive structured follow up and monitoring 2,3. This allows care teams to support patients through their AC therapy, intervene for adherence and pick up any side effects or adverse events for evaluation. 2 Enquire about or assess the presence of any adverse effects such as bleeding, symptoms of stroke or a VTE including pulmonary embolism NICE recommends patients DOACs should be reviewed every 3 months 3 1 Assess compliance to treatment and reinforce advice regarding the importance of a regular dosing schedule 3 Ask the person if they have been taking any other medicines including any bought over-the-counter

3 adherence and DOACs Studies have found that adherence in long-term conditions can average 50% 4,5. For DOAC AC therapy it has been estimated that as many as 1 in 3 patients can become nonpersistent before their first year of therapy is complete 6. 1 in 3 patients become nonpersistent within 6 months 6

the solution the DOAC support programme Our programme helps you to reduce time in clinic, follow NICE guidance and avoid transcription errors whilst staying connected to your patients.

4 the solution the DOAC support programme Our programme helps you to reduce time in clinic, follow NICE guidance and avoid transcription errors whilst staying connected to your patients. Delivered via engage, the DOAC support programme enables you to encourage tablet adherence by supporting patients to understand their anticoagulation therapy better and feel more in control of their health. comprehensive patient education Patients can now learn more about the benefits of their AC therapy with our easy-to-follow educational videos available at any time. Topics include: How AC therapy works Detailed information on your patient s specific DOAC How to use engage to submit digital reviews Any possible side effects and drug interactions

5 digital reviews Our programme helps you to reduce time in clinic by enabling patients to submit reviews via the engage app. You can schedule, view and file them back to your clinical system in INRstar. Patients self-report to you if they have: Experienced any side effects Missed any tablets Experienced any bleeding or clot symptoms This way you have visibility on how they are getting on and stay compliant with NICE guidance without extra workload for your team.

6 how it works Clinician activity Patient activity Discuss Discuss the programme with your patient and enrol them on the Self-Care page in INRstar. The next review will be automatically scheduled as a digital review due in 3 months. 1 2 Signs up to engage Your patient receives an with more info and links to engage. They create an account and log in. 3 4 Learns more about their anticoagulation therapy Your patient follows education videos on their specific anticoagulant, any possible side effects, bleeding and clotting symptoms and possible drug interactions. Submits a digital review Your patient fills in and submits a digital review via engage. View and file back Your patient s digital review arrives in the Results tab in INRstar. You can schedule, view and file them back to the clinician system. 5 6 Receives notification Your patient receives a notification that their review has been seen by their care team. If a new digital review has been scheduled, they will also receive the date of when it s due.

7 what benefits can you expect to see? We manage the whole set-up process for you, including all patient education and support so you can: Improve follow up and monitoring of DOAC patients Support medication adherence Follow NICE guidelines without significant impact on clinic time Improve health outcomes what are the benefits for patients? The DOAC support programme helps patients to: Gain knowledge, skills and confidence to feel more in control of their health Understand the benefits of their AC therapy and the importance of adherence Become familiar with any possible side effects of their specific DOAC as well as bleeding and clot symptoms Be aware of who to contact when needed start offering the DOAC support programme to patients now Call us now on or us at for more information. References 1 INRstar user survey April 2017, 1437 respondents 2 European Society of Cardiology. European Heart Rhythm Association Practical Guide on the use of new oral anticoagulants in patients with non-valvular atrial fibrillation. Europace. 2013:15: National Institute for Health and Care Excellence. Anticoagulation oral. Last revised: December Last accessed: 23 October Available at: 4 Bloom BS. Daily regimen and compliance with treatment. British Medical Journal, 2001, 323: bmj Wahl C., Gregoire JP, Teo K. et. al. Concordance, Compliance and Adherence in Health Care: Closing Gaps and Improving Outcomes. Healthc Q. 2005:8: doi: /hcq Jackevicius C.A.,Tsadok M.A., Essebag V.et al. Early non-persistence with dabigatran and rivaroxaban in patients with atrial fibrillation. Heart.2017:103: Originally published: 07 April. doi: /heartjnl

8 LumiraDx Care Solutions, Home of INRstar and engage 1 North Crofty, Tolvaddon Energy Park, Camborne, Cornwall. TR14 0HX T: +44(0) E: engage@lumiradx.co.uk

Southern Trust Anticoagulant Team

CLINICAL GUIDELINES ID TAG Title: Author: Speciality / Division: Directorate: Anticoagulation- Primary Care Guidance for reviewing patients on DOACs Southern Trust Anticoagulant Team Haematology Acute