Background

Anticoagulation management is changing and prescription of non-vitamin K oral anticoagulants (NOAC) is continuously and rapidly increasing in different indications like non-valvular atrial fibrillation (nvAF), prevention of deep venous thrombosis (DVT) and venous thrombo-embolism (VTE). Optimal adherence with these drugs is extremely important due to their short half-lives, the impact of side-effects and the risks of non-compliance. All means necessary, like effective and safe use of drugs, patient education, prescheduled follow-up and pharmacy data, should be considered to optimize adherence.

In most countries, there are insufficient physicians in primary care and the implications are that in real life, the time available to support adherence is limited and clearly inadequate. Pharmacists however are in an ideal place to support adherence and ensure that patients understand why they are taking their medicines and the risks if they don't take them. First of all, they are the most accessible healthcare providers and patients don’t need to book appointments or have to pay to seek professional medical advice. Secondly, they have specific competences to ensure effective and safe use of these drugs (detect inappropriate prescribing, prevent and resolve potential drug related problems and patient counselling services). Third, and last, they can detect potential non-compliance due to their pharmacy refill database.

If pharmacists want to play a key role in the care pathway of the anticoagulated patient, their knowledge on this new NOAC therapy needs to be excellent and continuously up-to-date, using the most recent guidelines and data. The International Pharmacists for Anticoagulation Care Taskforce (iPACT) is an expert group committed to enhancing the key role that pharmacists can play in anticoagulation management.