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AC Clinics and Covid-19

The Anticoagulation Forum conducted a webinar on Wednesday, March 25 entitled Management of Warfarin Patients Who Have Difficulty Getting INR Testing During COVID-19 Pandemic. Click or tap the title to see the recorded presentation, which centers on Warfarin management. Here are a few takeaways from the webinar, please feel free to add your observations below.

  • Prolong the intervals between INR assays
  • “Telecheck” bleeding history and diet with patients to delay INR assay visits
  • Provide point-of-care assays in isolated locations such as drive-throughs
  • Perform Medicare-prescribed history and physical assesment in drive-through
  • Maintain proper point of care instrument operating conditions, particularly temperature
  • Adjust dose on out of range point-of-care results without reflexing to a plasma-based assay
  • Use telemedicine to qualify patients for a switch to a DOAC
  • When switching anticoagulants, use an appropriate interval without lab monitoring
  • Since primaries are slammed, empower NPs and PAs to manage anticoagulation
  • Provide accurate information in a time of insecurity, employ shared decision making
Comments (1)
Anticoagulant Therapy
iceelance
Mar 26, 2020 2:53pm

At the Mayo Clinic in Arizona
At the Mayo Clinic in Arizona, we are heavily focused on the social distancing aspect of this crisis. Specifically in regards to coagulation testing, we have limited the number of seats in our waiting area and made sure the seating is not too close together. We are also embracing telemedicine for management of outpatient conditions. A lot of our transplant patients already have at home INR devices, so that makes it easier to manage their coumadin without exposing them to the hospital / clinic environment.
[From Lawrence “Lance” Williams III, Senior Associate Consultant, Associate Professor, Mayo Clinic College of Medicine and Science]

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