ADLM Guidance Document on Coagulation Testing in Patients Using Direct Oral Anticoagulants

Lindsay A L Bazydlo; Maximo J Marin; Anna E Merrill; Louise M Man; Olajumoke O Oladipo; Neil S Harris

doi:10.1093/jalm/jfaf155

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ADLM Guidance Document on Coagulation Testing in Patients Using Direct Oral Anticoagulants

Journal article

Peer reviewed

ADLM Guidance Document on Coagulation Testing in Patients Using Direct Oral Anticoagulants

Lindsay A L Bazydlo, Maximo J Marin, Anna E Merrill, Louise M Man, Olajumoke O Oladipo and Neil S Harris

The journal of applied laboratory medicine, Vol.10(6), pp.1675-1690

11/04/2025

DOI: 10.1093/jalm/jfaf155

PMID: 41189106

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Abstract

Background Coagulation testing has an important role in the diagnosis, monitoring, and therapeutic decision-making for patients with abnormal hemostasis. As the field of anticoagulation options has expanded, the introduction of direct oral anticoagulant (DOAC) drugs has provided an option for patients utilizing drugs that do not require routine monitoring. Patients on these drugs may still need coagulation testing for prognostic purposes, and there are a number of nuances to consider when performing coagulation testing in patients who are prescribed DOACs. Content This document provides guidance on the tests that may or may not be impacted by the presence of DOACs in the blood. A discussion is provided about specific coagulation tests used and the impact of testing samples with a DOAC present. Options are presented to help mitigate the impact of DOACs on the testing. In addition, this document discusses how to test for and interpret DOAC concentrations in specific patient populations.

Administration, Oral

Anticoagulants - administration & dosage

Anticoagulants - therapeutic use

Blood Coagulation - drug effects

Blood Coagulation Tests - methods

Blood Coagulation Tests - standards

Drug Monitoring - methods

Drug Monitoring - standards

Humans

Details

Title: Subtitle: ADLM Guidance Document on Coagulation Testing in Patients Using Direct Oral Anticoagulants
Creators: Lindsay A L Bazydlo - University of Virginia
Maximo J Marin - University of Florida
Anna E Merrill - University of Iowa
Louise M Man - University of Virginia
Olajumoke O Oladipo - Penn State Milton S. Hershey Medical Center
Neil S Harris - University of Florida
Resource Type: Journal article
Publication Details: The journal of applied laboratory medicine, Vol.10(6), pp.1675-1690
DOI: 10.1093/jalm/jfaf155
PMID: 41189106
NLM abbreviation: J Appl Lab Med
ISSN: 2576-9456
eISSN: 2475-7241
Publisher: OXFORD UNIV PRESS INC
Language: English
Date published: 11/04/2025
Academic Unit: Pathology; Injury Prevention Research Center
Record Identifier: 9985024250102771

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