By ODPHP’s Health Care Quality Division and CDC’s Center for Surveillance, Epidemiology, and Laboratory Services (CSELS)
Ever heard the phrase “There’s an app for that”? Recently, the Centers for Disease Control and Prevention (CDC), in partnership with the Georgia Institute of Technology, released the Anticoagulation Manager mobile app — and it’s now free to download from the Apple App Store!
The Anticoagulation Manager application is a clinical decision support tool designed to guide clinicians as they make decisions about prescribing anticoagulants — and to decrease errors in administration and laboratory testing. Each year, blood clots affect up to 900,000 Americans — and a third of people who have a blood clot will experience another in the next 10 years. Prescribing the right anticoagulant for patients is key to preventing these adverse events.
Anticoagulants are one of the 3 high-priority drug classes targeted in the National Action Plan for Adverse Drug Event Prevention (ADE Action Plan). A large study based on national emergency department (ED) data found that anticoagulants contribute to 17.6 percent of ED visits caused by an ADE. Anticoagulant-related ADEs most commonly result from medication errors. And the literature consistently shows that physicians experience challenges in ordering the clinical laboratory tests — such as prothrombin time or partial thromboplastin time — needed to learn how quickly a patient’s blood clots. Interpreting this information is necessary to decide whether or not to initiate anticoagulant therapy.
Almost a third of primary care physician encounters result in the ordering of such laboratory tests in the outpatient setting. Yet nearly 15 percent of physicians reported uncertainty about ordering the tests — and 8.3 percent were uncertain about interpreting the results. With over 500 million primary care patient visits a year, this level of uncertainty could affect 23 million patients annually. It raises significant concerns regarding the safe and effective use of laboratory testing — and, ultimately, preventable patient harm caused by prescribed medication therapy. Opportunities for new resources remain to help promote the safe management of anticoagulants.
The ADE Action Plan recommends the use of evidence-based prevention tools to help clinicians balance the benefits and risks associated with prescribing anticoagulants. For example, anticoagulation therapy may be too risky for a patient with a history of a major gastrointestinal bleed. But for patients at risk for stroke, such as those with atrial fibrillation, the benefit of anticoagulant therapy may outweigh the increased risk of bleeding associated with an anticoagulant. The Anticoagulation Manager app uses evidence-based guidelines to help clinicians make the best choice for every patient.
The app provides guidance on anticoagulation initiation for 6 conditions:
- Deep vein thrombosis/pulmonary embolism
- Nonvalvular atrial fibrillation
- Heparin-induced thrombocytopenia
- Mechanical heart valve
- Patent foramen ovale
- Pregnancy and fetal loss
The app also provides information on changing a patient’s anticoagulant therapy, as well as guidance on anticoagulant reversal. It includes information and guidance about all anticoagulants that are currently in use, including newer direct oral anticoagulants.
Prior to its release, the app went through comprehensive beta-testing with both physicians and pharmacists — and anticoagulation specialists nationwide extensively reviewed its algorithms.
The Anticoagulation Manager app supports the implementation of recommendations outlined in the ADE Action Plan, and its use is aligned with ODPHP’s efforts to prevent anticoagulant-related ADEs. Learn more about the Anticoagulation Manager from CDC.