Long term oral anticoagulation during COVID-19
NHS GGC Guidance: Conversion from warfarin to a direct oral anticoagulant (DOAC) during hospital admission for patients with non-valvular atrial fibrillation* (AF) or venous thromboembolism (VTE)
* non-valvular AF excludes patients with mechanical valves or significant mitral stenosis
- During the COVID-19 pandemic, it is recommended that patients admitted to hospital who take warfarin (or any other coumarin anticoagulant) for the indications listed above, should be considered for a switch to a suitable DOAC.
- The guideline available in the Therapeutics Handbook Conversion from Warfarin to a DOAC during the COVID-19 Pandemic includes full detail such as situations when patients should not be switched, recommended choice of DOAC and how to switch patients.
- Any changes made during hospital admission must be communicated to Primary Care in the Immediate Discharge Letter (IDL) so treatment with a DOAC can be continued after discharge.
- Adult Glasgow and Clyde Anticoagulation Clinics (GCAS) have a mechanism to identify patients who were switched from warfarin to a DOAC during the COVID 19 pandemic. Remember: all patients who are started or remain on warfarin must be referred to GCAS via Trakcare as per standard procedure described in this blog.
- This recommendation applies to prescribers in Acute Services across NHS GGC. This is to help reducing the need for patients to attend GCAS following discharge for INR checks.
- All warfarin patients in Primary Care should remain on their current treatment.
Published 03/06/2020. Medicines Update blogs are correct at the time of publication