A quality improvement project conducted in a GP practice in Greater Manchester to improve the monitoring and safety of patients on apixaban

摘要

Apixaban is a direct oral anticoagulant inhibitor (DOAC) thatprevents thrombin generation and thrombus development. 1 As perNational Institute for Health and Care Excellence (NICE) guidelines,those taking apixaban require regular follow up and monitoring dueto significant safety issues such as bleeding or renal impairment. 1-3 In many general practitioner (GP) practices, including KildonanHouse, monthly drug safety audits are carried out 5 and reviewedby the pharmacists. These reports ensure high-risk medicationsthat require regular monitoring are not overlooked as withoutthese requirements prescribers should not be authorising furthermedication. 5 However, although rivaroxaban, another DOAC was reviewed,as well as lithium and amiodarone, apixaban was not included. Iwanted to put measures in place to improve the system to meetthese standards and improve the monitoring and thus safety ofpatients on apixaban.