RPS endorses community pharmacy oral anticoagulant safety audit

A new community pharmacy oral anticoagulant safety audit, developed by the NHS Specialist Pharmacy Service (SPS), has been endorsed by the Royal Pharmaceutical Society (RPS).

The SPS said that NHS advice on safe anticoagulant therapy is more than 10 years old, and a number of new types of anticoagulant are now in common use. All anticoagulants are associated with several  patient safety hazards and the SPS said this audit will provide a safety check for patients prescribed anticoagulants and insight on the current use of alert cards and record books.

It added that the newer medicines including apixaban, dabigatran, edoxaban and rivaroxaban may not always be recognised as anticoagulants, and that this lack of recognition has contributed to various medication errors.

Reported errors include inappropriate continuation or discontinuation of anticoagulant therapy, inadvertent co-prescribing with other drugs such as non-steroidal anti-inflammatory drugs, and antiplatelets that increase the risk of bleeding, and concomitant prescribing with other anticoagulants such as heparin or warfarin.

The new anticoagulant safety audit aims to explore patients’ awareness of information about their anticoagulant medicine; monitor current use of anticoagulant alert cards, and audit compliance with national monitoring requirements for vitamin K antagonists. The data gathered will inform a national update of patient-held oral anticoagulant information and alert cards.

Under NHS regulations, community pharmacies are expected to complete two clinical audits per year. According to the SPS, the anticoagulant safety audit should take around two weeks and involve a minimum of 15 patients. The audit form can be downloaded from the Specialist Pharmacy Service website.