Anticipating the Need for DOAC Reversal: Understanding Risks and Planning Reversal Strategies
This educational activity is sponsored by Postgraduate Healthcare Education, LLC (PHE) and supported by an independent educational grant from Portola.
Toby C. Trujillo, PharmD, FCCP, FAHA, BCPS-AQ
University of Colorado Skaggs School of Pharmacy
Toby C. Trujillo, PharmD, FCCP, FAHA, BCPS-AQ has no actual or potential conflicts of interest in relation to this program.
The clinical reviewer, Jeannette Wick, RPh, MBA, FASCP, has no actual or potential conflicts of interest in relation to this program.
Susanne Batesko, RN, BSN, Robin Carrino and Katherine Wandersee, as well as the planners, managers, and other individuals, not previously disclosed, who are in a position to control the content of Postgraduate Healthcare Education (PHE) continuing education activities hereby state that they have no relevant conflicts of interest and no financial relationships or relationships to products or devices during the past 12 months to disclose in relation to this activity. PHE is committed to providing participants with a quality learning experience and to improve clinical outcomes without promoting the financial interests of a proprietary business.
Postgraduate Healthcare Education, LLC is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.
Universal Activity Number: 0430-0000-21-071-H01-P
Credits: 2.0 hours (0.2 ceu)
Type of Activity: Application
Fee Information: There is no fee for this educational activity.
Estimated time to complete activity: 120 minutes
June 30, 2021
June 30, 2022
This accredited activity has been designed for pharmacists.
How to Earn Credit
Participants must 1) read the learning objectives and faculty disclosures; 2) study the educational activity; and 3) complete the posttest and evaluation form directly after the activity within a maximum of 60 days of participating in the activity. To answer the questions, click on your selected choice for each answer then proceed to the next question. Once completed, click on the Grade Exam button at the bottom of the page. Your posttest will automatically be graded. If you successfully complete the posttest (score of 70% or higher), your statement of participation will be made available immediately. Click on the View Statement of Participation link and print the statement for your records. If you receive a score lower than 70%, you will receive a message notifying you that you did not pass the posttest. You will have 2 opportunities to pass the posttest. To receive Credit, you must provide your date of birth and NABP number. All Credit information will be uploaded into CPE monitor within 30 days.
Because DOAC use is increasing, bleeding events related to these agents are likely to increase even though they have a lower bleeding risk. New reversal agents are becoming available for patients who require rapid reversal of anticoagulation in the event of unplanned surgery or major bleeding, such as ICH. Pharmacists need education on the burden of ICH, reversal agents, and guidelines/recommendations so that they may participate in formulary decisions and protocol development for DOAC reversal. The ability to rapidly address bleeding issues can lead to improved patient outcomes. Having pharmacist experts available can facilitate these improvements.
Upon completion of this educational activity, participants should be better able to:
- Review the burden of intracranial hemorrhage (ICH) on patients and healthcare resources, including the impact of ICH in patients taking oral anticoagulants such as vitamin K antagonists or direct oral anticoagulants (DOACs)
- Examine agents used for reversal of anticoagulation in DOAC-associated bleeding events, including DOAC-specific agents available or in development
- Apply guideline recommendations for DOAC reversal or interruption to clinically relevant situations
- Develop strategies to improve protocols that include reversal of anticoagulation and formulary management related to DOAC-treated patients who require surgery or experience bleeding events
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Disclosure of Unlabeled Use and Disclaimer
The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of Postgraduate Healthcare Education, LLC or Portola. Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patients' conditions, and possible contraindications on dangers in use, (review of any applicable manufacturer's product information) and comparison with recommendations of other authorities.
The author, sponsor, and publisher of this continuing education activity have made all reasonable efforts to ensure that all information contained herein is accurate in accordance with the latest available scientific knowledge at the time of acceptance for publication. However, because information regarding drugs (their administration, dosages, contraindications, adverse reactions, interactions, special warnings, precautions, etc.) is subject to constant change, the reader is advised to check the manufacturer's package insert for information concerning recommended dosages and potential problems and cautions prior to dispensing or administering the drug. Special precautions should be taken when a drug is new, or highly toxic, or is unfamiliar to the dispenser or administrant. This educational activity may contain discussion of published and/or investigational uses of agents that are not approved by the U.S. Food and Drug Administration (FDA). Neither the publisher nor sponsor promotes the use of any agent outside of approved labeling. Statements made in this activity have not been evaluated by the FDA.