Project Information

Outcomes of a Pharmacist-Monitored Direct Oral Anticoagulant Service in the Outpatient Setting

Project Description: At UF Health Internal Medicine at the Medical Plaza, the pharmacotherapy clinic monitors patients prescribed direct oral anticoagulants (DOACs) to ensure proper dosing, patient adherence, and to assess for signs or symptoms of bleeding or thromboembolism. The intervals at which these patients are followed-up is based on the European Heart Rhythm Association guidelines. In these guidelines, follow-up is based on renal function, health status, and age (1). A previous retrospective evaluation was conducted to determine if patients at two UF Health Internal Medicine clinics were correctly prescribed DOACs (2). As the next step, this prospective quality improvement project is designed to assess outcomes of patients enrolled in the pharmacist-managed direct oral anticoagulant service. References: 1. Heidbuchel H, Verhamme P, Alings M, et al. Updated European Heart Rhythm Association practical guide on the use of non-vitamin K antagonist anticoagulants in patients with non-valvular atrial fibrillation. Europace. 2015;17: 1467-1507. 2. Rieser K, Rosenberg E, Vogel Anderson K. Evaluation of the Appropriateness of Direct Oral Anticoagulant Selection and Monitoring in the Outpatient Setting. Journal of Pharmacy Technology. 2017;33(3):108-113.

QPI: Kaylie, Smith, (

Collaborators: Katherine, Vogel Anderson, (

Advisors: Katherine, Vogel Anderson, (

UF Health Big Aims: Increase Value None

MeSH Keywords: Ambulatory Care, Anticoagulants, Pharmacists, Outcome Assessment (Health Care), Medication Adherence