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The Use of Direct Acting Oral Anti-Coagulants in Vulnerable Populations

Provided by American Academy of CME, Inc.

Supported by an educational grant from Janssen Pharmaceuticals, Inc., administered by Janssen Scientific Affairs, LLC.

Release date

September 30, 2021

Expiration date

September 30, 2022

Estimated time to complete

2.0 hours

Clinical Need

Recommendations and evidence surrounding the use of DOAC’s in special populations continue to evolve to address concerns of use in patients with obesity, renal disease, active malignancy, and older adults. DOAC’s are a widely prescribed newer class of medications with emerging clinical recommendations and evidence for safe use. Pharmacists have a key role to play as part of the care team in formulating anticoagulation regimens that are appropriate for individual patients, and would benefit from education on the efficacy and safety of DOAC’s in vulnerable populations.

Faculty Educator

Maya R. Chilbert (Holsen), PharmD, BCCP
Clinical Assistant Professor
University at Buffalo School of Pharmacy and Pharmaceutical Sciences

Target Audience

This activity is designed for pharmacists actively engaged in the care of patients with atrial fibrillation and/or at risk for VTE. Other members of the care team may also participate.

Educational Objectives

After participating in this educational activity, learners should be better able to:

  1. Identify the indications, doses, and pharmacokinetic properties of direct acting oral anti-coagulants (DOAC’s)
  2. Compare the risk of bleeding among DOAC’s based on concomitant diseases
  3. Select appropriate anticoagulation therapy for individual patients based on concomitant diseases
  4. Assess the pharmacist’s role in formulating anticoagulation regimens for patients in high-risk groups


Joint Accreditation StatementIn support of improving patient care, American Academy of CME, Inc. is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.


acpeThis activity provides 2.0 ACPE contact hours (0.20 CEUs) of continuing education credit. Universal Activity Number JA4008191-0000-21-004-H01-P, Application

Disclosure Statement

According to the disclosure policy of the Academy, all faculty, planning committee members, editors, managers and other individuals who are in a position to control content are required to disclose any relationships with any ineligible company(ies). The existence of these relationships is not viewed as implying bias or decreasing the value of the activity. Clinical content has been reviewed for fair balance and scientific objectivity, and all of the relevant financial relationships listed for these individuals have been mitigated.

Faculty Educator
Maya R. Chilbert (Holsen), PharmD, BCCP
No relevant financial relationships with any ineligible companies.

Planning Committee
John JD Juchniewicz, MCIS, CHCP, FACEHP, Edward Moylan, RPh, Wendy Gloffke, PhD and Paul Miniter, MS - No relevant financial relationships with any ineligible companies.

Clinical Reviewer
Philip Coco, PharmD has no relevant financial relationships with any ineligible companies.

This activity will not review off-label or investigational information.


The opinions expressed in this educational activity are those of the faculty, and do not represent those of the Academy. This activity is intended as a supplement to existing knowledge, published information, and practice guidelines. Learners should appraise the information presented critically and draw conclusions only after careful conideration of all available scientific information.

Method of Participation

There are no fees to participate in the activity.  Participants must review the activity information including the learning objectives and disclosure statements, as well as the content of the activity. To receive CPE credit for your participation, please complete the post-test (achieving a passing grade of 70% or greater), and program evaluation. Your certificate can be printed immediately. For pharmacists, a statement of credit will be issued through CPE Monitor in 6-8 weeks. Only pharmacist learners who provided valid NABP e-Profile ID numbers and month and day of birth (MMDD) will be submitted to CPE Monitor for official record of credit.

Hardware/Software Requirements

Please ensure the computer you plan to use meets the following minimum requirements:

  • Operating System: Windows 98 or higher & Macintosh 2.2 or higher
  • Internet Browser (Mac &/ Windows): Internet Explorer 6.0 or higher, Google Chrome, Safari 5.0.6 or higher, Firefox 3.0.3 or higher & Opera 5 or higher
  • Broadband Internet connection: Cable, High-speed DSL & any other medium that is internet accessible
  • Monitor Screen Resolution: 320 x 480 or higher
  • Media Viewing Requirements: Adobe Reader, Microsoft Powerpoint, Flash Player & HTML5


For more information about the American Academy of CME privacy policy, please access http://www.academycme.org/privacy.htm


For any questions, please contact: CEServices@academycme.org


© 2021. This CPE-certified activity is held as copyrighted © by American Academy of CME, Inc. Through this notice, the Academy grants permission of its use for educational purposes only. These materials may not be used, in whole or in part, for any commercial purposes without prior permission in writing from the copyright owner(s).