Journal article
Factors associated with availability of anticoagulation reversal agents in rural and community emergency departments
American journal of health-system pharmacy, Vol.75(2), pp.72-77
01/15/2018
DOI: 10.2146/ajhp160520
PMID: 29317397
Abstract
Results of a study of anticoagulation reversal agent availability in rural and community hospital emergency departments (EDs) are reported.
A cross-sectional telephone survey was conducted to test the hypothesis that anticoagulation reversal agents are not commonly stocked in low-volume EDs. In phase 1 of the study, a physician, pharmacist, or nurse manager at a sample of EDs in 1 state was surveyed to characterize anticoagulation reversal agent availability and the presence or absence of reversal protocols; in phase 2, follow-up qualitative interviews were conducted with hospital pharmacists selected by purposive sampling to identify barriers to availability.
Among the 103 EDs represented in the survey, 87 (84%) stocked fresh frozen plasma, 14 (14%) stocked 4-factor prothrombin complex concentrate (4F-PCC), and 2 (2%) stocked activated 4F-PCC. Forty-one EDs (40%) had a warfarin reversal protocol, but only 2 (2%) EDs had a protocol for direct oral anticoagulant reversal. ED volume and neurology coverage were significantly associated with reversal agent availability (
= 0.014) and warfarin protocol availability (
< 0.001). Identified factors contributing to reversal agent nonavailability were product cost, lack of knowledge of drug availability, and concerns about shelf life.
An investigation of rural and community hospitals in 1 state revealed that the institutions rarely have specialized anticoagulation reversal drugs available. Cost and infrequency of utilization were 2 commonly cited reasons for reversal agent nonavailability.
Details
- Title: Subtitle
- Factors associated with availability of anticoagulation reversal agents in rural and community emergency departments
- Creators
- Brett A Faine - Department of Pharmaceutical Care and Department of Emergency Medicine, University of Iowa Hospitals and Clinics, Iowa City, IA brett-faine@uiowa.eduJulie Amendola - Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IAJordan Homan - Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IAAzeemuddin Ahmed - Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IANicholas Mohr - Department of Emergency Medicine and Department of Anesthesia, University of Iowa Carver College of Medicine, Iowa City, IA
- Resource Type
- Journal article
- Publication Details
- American journal of health-system pharmacy, Vol.75(2), pp.72-77
- DOI
- 10.2146/ajhp160520
- PMID
- 29317397
- NLM abbreviation
- Am J Health Syst Pharm
- ISSN
- 1079-2082
- eISSN
- 1535-2900
- Publisher
- England
- Language
- English
- Date published
- 01/15/2018
- Academic Unit
- Management and Entrepreneurship ; Epidemiology; Emergency Medicine; Pharmacy Practice and Science; Anesthesia; Injury Prevention Research Center
- Record Identifier
- 9984024529102771
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