Anticoagulation Clinic
As published in Chest: The Cardiopulmonary and Critical Care Journal in January 2001, (volume 119, issue 1; supplement), evidence suggests that patients regularly seen in an anticoagulation clinic have better outcomes than patients managed by their primary care physicians. These patients have fewer episodes of major bleeding and recurrent thromboembolism (blood clots). It is believed these results stem from a multidisciplinary approach, frequent follow–up with the care providers and more frequent monitoring of therapy via blood tests.
The IHTC’s Anticoagulation Clinic is a multidisciplinary comprehensive approach to treating patients who are on anticoagulation therapy (e.g., Coumadin® or low molecular weight heparin). Patients are seen at least every six months by the Anticoagulation Clinic staff. The clinic is led by a nurse practitioner experienced in the treatment of thrombotic (clotting) disorders. A board certified hematologist is available during clinic should additional consultation be required. Following each patient’s visit to the Anticoagulation Clinic, the nurse practitioner reviews the patient’s medical issues with the hematologist. These healthcare providers are supported, on an as–needed basis, by the IHTC’s physical therapist (for strengthening exercise therapy, especially involving the legs related to thrombotic pain and swelling), nutritionist, genetic counselor and social worker (largely involving insurance coverage counseling).
In the clinic, patients receive education about anticoagulation therapy. They are monitored for dietary and drug interactions with their particular anticoagulant. If relevant, information is presented on their specific genetic or acquired defect. And, if necessary, counseling on the management of symptoms is provided. Periodically, additional laboratory tests may be required to monitor either the effectiveness of the therapy or to provide additional information as to why a blood clot may have occurred. Other laboratory studies ordered during a visit may serve as an early warning and help prevent an adverse event.
