An Evaluation of Oral Anticoagulant Safety Indicators by England’s Community Pharmacies

Abstract

Background: Anticoagulants are life-saving medicines that can prevent strokes for patients diagnosed with atrial fibrillation (AF) as well as treating patients with venous thromboembolism (VTE), but when used incorrectly, they are frequently associated with patient harm. Aim: To evaluate the impact of community pharmacy teams on optimising patient knowledge and awareness and improving medication safety from the use of anticoagulants. Methods: Two national audits, consisting of 17 questions assessing and improving patients’ understanding of anticoagulant therapy, identifying high-risk patients, and contacting prescribers when clinically appropriate were incentivised for England’s community pharmacies in 2021–2022 and 2023–2024 using the Pharmacy Quality Scheme (PQS) commissioned by NHS England. Results: Approximately 11,000 community pharmacies audited just under a quarter of a million patients in total, whilst making almost 150,000 interventions for patients taking oral anticoagulants, i.e., identifying and addressing medication issues which could increase the risk of bleeding/harm. Out of the 111,195 patients audited in 2021–2022, only 24,545 (23%) patients were prescribed vitamin K antagonists. The remaining patients were prescribed direct oral anticoagulants (DOACs). By 2023–2024, this decreased to 17,043 (16%) patients. Most patients knew that they were prescribed an anticoagulant (95.6%, 106,255 in 2021–2022 and 96.5%, 101,006 in 2023–2024, p p p p p < 0.001). Conclusions: Community pharmacy teams are well placed in educating and counselling patients on the safe use of anticoagulants and ensuring that all patients are correctly monitored.

Keywords

• anticoagulants
• medicine safety
• community pharmacy
• pharmacists
• pharmacy quality scheme
• primary care