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Documentations Published by the iPact network on behalf of iPact |
Rapid Referral to a One-Stop AF Clinic Abstract |
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Benefits of active involvement of community pharmacists in Know Your Pulse awareness campaign
Opportunistic case-finding is recommended as a means to identify the one-third of people with undiagnosed AF. Recent studies have demonstrated the benefit of engaging community pharmacists to ’screen’ for these patients. Know Your Pulse is a proprietary initiative of the UK’s leading heart rhythm charity that facilitates manual pulse rhythm checks for the general public and connects those found to have an irregular rhythm with their primary care practitioner.
Author: Sotiris Antoniou, John Papastergiou, Fabio de Rango, Dale Griffiths, Nadya Hamedi, Helen Williams, Salvador Tous, Trudie Loban, Filipa Alves da Costa, Maria Dolores Murillo |
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Pharmacists’ confidence when providing pharmaceutical care on anticoagulants, a multinational survey
Background Guidelines on the management of
orally anticoagulated patients are continuously evolving, leading to an increased need for pharmacists to be fully integrated in care provision. Objective To identify self-reported gaps in confidence among practicing pharmacists in the area of anticoagulation. Setting Pharmacists in different work settings in different countries. Method Cross-sectional international survey from October 2015 till November 2016 among pharmacists working in different settings to assess their level of confidence when delivering anticoagulants as well as to identify possible educational needs regarding this medication class. Validation of the survey was ensured. Results Responses from 4212 pharmacists originating from 18 countries were obtained. |
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Pharmacists’ confidence when providing pharmaceutical care on anticoagulants, a multinational survey
Guidelines on the management of orally anticoagulated patients are continuously evolving, leading to an increased need for pharmacists to be fully integrated in care provision. Objective To identify self-reported gaps in confidence among practicing pharmacists in the area of anticoagulation.
Pharmacists in different work settings in different countries. Method Cross-sectional international survey from October 2015 till November 2016 among pharmacists working in different settings to assess their level of confidence when delivering anticoagulants as well as to identify possible educational needs regarding this medication class. Validation of the survey was ensured. Responses from 4212 pharmacists originating from 18 countries were obtained. Pharmacists’ level of confidence was significantly higher (p < 0.001) when advising patients on vitamin K antagonists (VKAs) versus non-vitamin K antagonists (NOACs). In general, hospital pharmacists displayed higher confidence levels compared to community pharmacists when advising patients on anticoagulation (p < 0.001). Two distinct patterns of confidence levels emerged relating to basic and advanced pharmaceutical care. Confidence levels when providing advanced pharmaceutical care were significantly higher for Oceania and lower for South America (p < 0.005). Pharmacists felt more confident in supporting patients receiving VKAs compared to the more recently introduced NOACs. With the increasing use of NOACs and the risks pertaining to anticoagulation therapy, it is essential to invest in education for pharmacists to address their knowledge gaps enabling them to confidently support patients receiving oral anticoagulants. Author: John Papastergiou, Nadir Kheir, katerina.ladova, Silas Rydant, Fabio de Rango, Sotiris Antoniou, Reka Viola, Lola Murillo, Stephane Steurbaut, Filipa Alves da Costa |
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Knowledge and needs assessment of Belgian pharmacists
The results of the Belgian data of the iPACT survey.
Author: Souad Moudallel, Anke Smeets, Silas Rydant, Fabio de Rango, John Papastergiou, Sotiris Antoniou, Bart van den Bemt, Nadir Kheir, Filipa Alves da Costa, Stephane Steurbaut Tags: Pharmcare 2017 (Belgium), Dutch
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Know your pulse awareness campaign: involving pharmacists for greater outreach
Evidence suggests that up to 1/3 of stroke-related deaths are attributable to atrial fibrillation (AF). This condition, frequently asymptomatic, is estimated to be 50% undiagnosed. Worldwide ageing of the population will impact on the prevalence of heart rhythm disorders, suggesting the need for awareness raising. The Arrhythmia Alliance annually develops an awareness campaign aiming to contribute to improve public awareness, including teaching individuals to check their own pulse rhythm. This year, iPACT created a partnership with the Atrial Fibrillation Association (AFA) to test a model where pharmacists became actively involved in pulse check.
The purpose is to educate people in London about AF and how to undertake manual pulse check; and to screen for undiagnosed AF. Author: Nadya Hamedi, Helen Williams, Becky Bell, Trudie Loban, Sotiris Antoniou, Filipa Alves da Costa Tags: PCNE 2017
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Awareness campaign on Atrial Fibrillation in Portuguese community pharmacies. Preliminary results
In Portugal, Atrial Fibrillation (AF) has a rate of under-detection of, approximately, 36.0% and one in three strokes is due to AF. Community pharmacies are the most easily accessible health care resource for citizens, and constitute therefore the ideal venue to search for people with possible cardiac abnormalities, such as AF.
The purpose is to raise awareness of AF by conducting a screening campaign aiming to search for people with signs and/or symptoms suggestive of AF in the general population; and to pulse take all patients agreeing to participate. Author: Filipa Alves da Costa, Sotiris Antoniou, Trudie Loban, João Pedro Aguiar Tags: PCNE 2017
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Benefits of active involvement of community pharmacists in ‘Know your pulse awareness’ campaign.
Atrial fibrillation is the most common cardiac arrhythmia globally, responsible for one third of strokes, and often resulting in death or incapacity. This condition, frequently asymptomatic, is estimated to be up to 50% undiagnosed. Reducing this risk with appropriate detection and management strategies offers substantial economic and patient benefits. The International Pharmacist for Anticoagulation Care Taskforce- [iPACT] created a partnership with the Atrial Fibrillation Association (AFA) to test a model whereby pharmacists are actively involved in opportunistic screening for AF initially in all ages as a proof of concept.
Author: Contact person: Sotiris Antoniou and Filipa Alves da Costa, John Papastergiou, Fabio de Rango, Salvador Tous, Nadya Hamedi, Helen Williams, Dale Griffiths, Trudie Loban, Lola Murillo Tags: ESC 2017
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Are Confidence Levels of Hospital Pharmacists Different from Other Pharmacists in the Management of Anticoagulation Therapy Preliminary Results from a Multinational Pharmacists Needs Assessment Survey.
The purpose of this needs assessment survey is to identify self-reported gaps in competences and confidence among practicing pharmacists in the area of anticoagulation; to identify variances in confidence levels between community and hospital pharmacists; and to examine areas of anticoagulation with varying needs.
These results highlight the apparent lack of confidence by both community and hospital pharmacists when discussing anticoagulation, particularly DOACs. Future continuing education programs should be developed on electronic platforms focusing on practical clinical themes that apply across all settings. Author: John Papastergiou, Fabio de Rango, Silas Rydant, Stephane Steurbaut, Sotiris Antoniou, Filipa Costa, Bart van den Bemt, Nadir Kheir Tags: EAHP 2017
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Pharmaceutical Counselling on Anticoagulation – Identifying Needs of German Community Pharmacies
The role of the community pharmacist has been evolving from product-focused to patientoriented. In this context, pharmaceutical counselling becomes especially important to ensure safe and effective use of drugs. This survey is the German arm of an international survey conducted by the international pharmaceutical anticoagulation care task force (iPACT).
The objective is to identify the educational needs of German community pharmacies assessed by reported self-confidence when advising patients on anticoagulants. Author: Anna Laven, Fabio de Rango, Silas Rydant, Filipa Costa, Sotiris Antoniou Tags: PCNE 2017
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Canadian pharmacists needs assessment in the management of anticoagulation therapy.
Author: John Papastergiou, Fabio de Rango, Sotiris Antoniou, Stephane Steurbaut, Filipa Alves da Costa, Silas Rydant, Bart van den Bemt, Xiang Wang, Nadir Kheir
Tags: FIP 2016
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The impact of Pharmaceutical Care interventions on the effective and safe use of oral anticoagulants -- A systematic review
Oral anticoagulants (OAC) have a beneficial effect on the long term survival of patients with atrial fibrillation and venous thromboembolism. However OACs have also side effects such as bleeding, especially when used inappropriately. Pharmaceutical care interventions aim to optimize medicines use and improve patient health outcomes. The literature lacks a review on the impact of Pharmaceutical Care interventions in patients using OAC. Therefore, we systematically assessed the impact of pharmaceutical Care interventions on the effective and safe use of OAC compared to usual care.
Author: Nikki Wartenberg, Nikki Damen, Kurt Hersberger, Sotiris Antoniou, Silas Rydant, Isabelle Arnet, Bart van den Bemt Tags: ESCP 2016
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Multi-national pharmacists needs assessment in the management of anticoagulation therapy.
The International Pharmacists for Anticoagulation Care Taskforce (iPACT) is an expert group committed to enhancing the key role that pharmacists play in anticoagulation management. Pharmacists are ideally suited to monitor patients in this therapeutic area, however, an assessment of their knowledge in providing consultations has not been formally evaluated. The purpose of this needs assessment survey is to identify self-reported gaps in competences and confidence among practicing pharmacists in the area of anticoagulation and to identify variances in confidence levels between different countries.
Author: John Papastergiou, Fabio de Rango, Filipa Costa, Sotiris Antoniou, Stephane Steurbaut, Silas Rydant, Bart van den Bemt, Nadir Kheir Tags: ESCP
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Defining an international framework for pharmacy standards on oral anticoagulation
To design and characterise a framework of international pharmacy standards for pharmaceutical care application on oral anticoagulation for prevention of Atrial Fibrillation (AF) related strokes.
A clearly defined framework of international standards was developed as a clinical tool and quality assurance to optimise the delivery of care for oral anticoagulation in prevention of AF-related strokes. It will support pharmacists and their teams to develop their professional practice, improve services, and deliver safe and high quality patient care across all pharmacy settings. Author: Nadya Hamedi, Craig Coleman, Kurt Hersberger, Niels Kristen, Nadir Kheir, Foppe Van Mil, Bart van den Bemt, Silas Rydant, Sotiris Antoniou Tags: ESCP 2016
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Canadian pharmacists needs assessment in the management of anticoagulation therapy.
The purpose of this needs assessment survey is to identify self-reported gaps in competences and confidence among practicing pharmacists in the area of anticoagulation.
Author: John Papastergiou, Fabio de Rango, Sotiris Antoniou, Nadir Kheir, Stephane Steurbaut Tags: FIP 2016
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Workshop 'adequate pharmaceutical care in oral anticoagulation'
Workshop 'adequate pharmaceutical care in oral anticoagulation
A 2h workshop was developed by iPACT for ESCPand had over 40 participants. The workshop had a precourse (e-learning) and the workshop itself, The focus was to discuss the big challenges with oral anticoagulation (correct dosing, adherence) through real cases. Author: Stephane Steurbaut, Bart van den Bemt, Silas Rydant |
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iPACT, the International Pharmacists Anticoagulation Care Taskforce – how can it help me?
Author: Niamh O'Hanlon
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DUTCH - Guideline Media Release |
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Interprofessional guideline to support patients receiving oral anticoagulation therapy [Short Version] |
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Interprofessional guideline to support patients receiving oral anticoagulation therapy [Full Version] |
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Creating an Interprofessional guideline to support patients receiving oral anticoagulation therapy: a Delphi exercise |
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Documentations Published by the iPact Network as Part of Members’ Professional Projects |
Pulse Check as a Tool to Raise Awareness of Atrial Fibrillation in Czech Community Pharmacies |
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Direct Oral Anticoagulant Use in Atypical Thrombosis-Related Conditions.
Author: Chang C, Hoyos M , Owusu Y , Elewa H
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Trends in oral anticoagulant use in Qatar: a 5-year experience
Author: Elewa H , Alhaddad A , Al-Rawi S, Nounou A , Mahmoud H , Singh R
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Approaches to Direct Oral Anticoagulant Selection in Practice.
Author: Paravattil B, Elewa H.
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Appropriateness of Dabigatran and Rivaroxaban Prescribing in Qatar: A 5-Year Experience.
Author: Elewa H, El-Makaty H, Ali Z.
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Patients’ knowledge on oral anticoagulant treatment in Hungary |
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Rapid Referral to a One-Stop AF Clinic Poster |
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2018 - White Paper on inequalities and unmet needs in the detection of atrial fibrillation (AF) and use of therapies to prevent AF‑related stroke in Europe |
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Other Literature in the Area of Anticoagulation of Interest to the iPact Network |
A systematic review of clinicians' views and experiences of direct‐acting oral anticoagulants in the management of non‐valvular atrial fibrillation
Author: Daria Generalova , Scott Cunningham , Stephen J. Leslie , Gordon F. Rushworth , Laura McIver , Derek Stewart
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Pharmacist-led atrial fibrillation reviews save NHS £82m |
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High levels of Time in Therapeutic Range (TTR) demonstrated by Community Pharmacy Anticoagulation Service (CPAMS).
CPAMS is an initiative in New Zealand whereby community pharmacists provide a reliable, easily accessible warfarin management service using point of care testing. Previous results demonstrated the value of warfarin service and the high level of patient engagement measured by the TTR achieved, adherence to test date and patient and general practitioner satisfaction surveys.
This is the report of the impact of a wider service rollout. Author: Dale Griffiths |
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Infographic on the NOAC
Around 12,500 strokes are caused by atrial fibrillation (AF) in the UK each year, and 7,100 of these are preventable with appropriate anticoagulation. Four new oral anticoagulants (NOACs) are now available in the UK in addition to warfarin.
In this link you'll find a handy oversight of the most relevant topics when using NOAC. Author: The Pharmaceutical Journal |
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Reports |
Analýza možností farmaceutické péče o pacienty s antikoagulační terapií v ČR a SR
Author: Kateřina MALÁ-LÁDOVÁ,, Anna OLEÁROVÁ,, Filipa ALVES DE COSTA
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2018 DRM-F Annual Report |
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Newsletters |
September 2019 External Newsletter - "The opportunity for Pharmacy in delivering safe and effective care to patients" |
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May 2019 External Newsletter - Improving Patient Adherence to Anticoagulant Medication |
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Relevant Educational Materials |
Ensuring the pharmacy profession has the knowledge and skills to manage patients receiving anticoagulation
After completing this module, you should be able to:
- Answer if pharmacists are well suited to provide pharmaceutical care to patients on vitamin K antagonists (VKAs) and direct oral anticoagulants (DOACs) - Explain the importance of developing pharmacists’ skills and knowledge to manage patients on OACs - Acknowledge in what domains regarding VKAs and DOACs further training is required, and how this can be achieved Author: Stephane Steurbaut |
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Optimising adherence in atrial fibrillation
In this video module, Filipa Alves da Costa describes the importance of medication adherence, focusing on patient adherence to treatment. This module is a recording of a satellite event held at the 2017 conference of the European Association of Hospital Pharmacists.
After completing this module, you should be able to: - Understand the determinants of medication adherence - Understand the impact of suboptimal adherence - Understand strategies for enhancing medication adherence, focusing on patient interventions, including counselling strategies. Author: Filipa Alves da Costa |
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The importance of adherence to non-vitamin K oral anticoagulants in non-valvular atrial fibrillation
In this video module, Craig Coleman discusses the importance of medication adherence, in the context of novel oral anticoagulants (NOACs) in patients with non-valvular atrial fibrillation (AF). This module is a recording of a satellite event held at the 2017 conference of the European Association of Hospital Pharmacists.
After completing this module, you should be able to: - Describe the difference between adherence and persistence - Describe how adherence can be measured - Understand the predictors of poor medication taking behaviour - Review the evidence for measures to improve adherence. Author: Craig Coleman |
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Anticoagulants: show me the evidence!
Optimal oral anticoagulant therapy requires careful consideration of patient's needs and an understanding of the efficacy, safety, pharmacokinetics of the anticoagulants, and the methods used to measure their effects. Warfarin, a vitamin K antagonist, has been the mainstay of oral anticoagulation therapy for over several decades. However, warfarin is associated with a number of difficulties, including the need for constant INR monitoring, dosing adjustments, dietary restrictions, and clinically significant drug interactions.
Finding an alternative to warfarin has been a focus of recent research. The newer oral anticoagulants that inhibit factor IIa or factor Xa have more predictable pharmacokinetics, fewer drug and diet interactions, and no need for routine laboratory monitoring and dose adjustments. Adherence is especially important with these new anticoagulants because they have relatively short half lives. The pharmacist has a significant role in keeping updated with these new anticoagulant drugs, educating patients about their drugs, and the importance of adhering to their anticoagulant therapy. You will be invited to complete a survey at the end of the course to claim your ACPE certificate. Author: Sotiris Antoniou, Craig Coleman, Filipa Alves da Costa, Helen Williams |
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Medicines optimisation: improving anticoagulation globally
In this video module, Sotiris Antoniou discusses the importance of optimal anticoagulation to prevent stroke in patients with atrial fibrillation. This module is a recording of a satellite event held at the 2017 conference of the European Association of Hospital Pharmacists.
Learning outcomes: After completing this module, you should be able to: - Understand the evidence supporting the use of anticoagulants compared to antiplatelets to prevent stroke in patients with atrial fibrillation (AF) - Describe key guideline recommendations for anticoagulation in patients with AF - Assess the risk of stroke in patients with atrial fibrillation - Assess the risk of bleeding in patients who are taking anticoagulation. Author: Sotiris Antoniou |
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Anticoagulation - from theory to practice
At the end of the course participants should be able to:
- Explain the differences between anticoagulants, their pharmacodynamics and pharmacokinetics - Describe the management of different anticoagulants in perioperative settings - Describe and interpret the laboratory results used to assess anticoagulation effect - Define the possibilities for reversal of anticoagulation effect. Author: Katerina Mala, Stephane Steurbaut, Bart van den Bemt |
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Virtual Avatar Anticoagulation Training
This is an interactive training exercise which uses a clinical avatar (virtual patient). It helps pharmacists to improve their knowledge on anticoagulation and to practice how to counsel a newly diagnosed atrial fibrillation (AF) patient
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Presentations |
The importance of atrial fibrillation population screening from the view of pharmacists
Author: Katerina Mala-Ladova
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FIP Member Meeting Presentation - September 2018 |
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March 27 2019 - iPACT Status Meeting 1 EAHP Presentation |
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ESCP Workshop Antwerp May 2019 |
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iPACT Presentation - Brazil, June 17th 2017 |
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iPACT Presentation - Brazil, June 16th 2017 |
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Value of Know Your Pulse Campaigns - ESCP 2017 |
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