Perspectives: Lessons Learned From VKAs

Sarah A. Spinler

Sarah A. Spinler


  • Professor of Clinical Pharmacy
  • Department of Pharmacy Practice and Pharmacy Administration
  • Philadelphia College of Pharmacy
  • University of the Sciences in Philadelphia
  • Philadelphia, Pennsylvania

Learnings from managing VKA therapy

One of the lessons we learned is the importance of medication adherence, which was typically reinforced at the clinic visit when an INR was checked with warfarin.

But with anticoagulants where routine INR monitoring may not be required, healthcare providers must be vigilant about adhering to following up with patients, to being communicative with them about when to restart anticoagulation if it has been discontinued, to maintain their medication dosing, and to be consistent with their prescribed regimen.

So this means appropriate education at the patient level, and it also means making sure that patients have access to their medication.

With warfarin, we had a management strategy, by which, on the discharge note, you would include the date, time, and provider that would receive the INR results. But with other anticoagulants, it’s making sure that the patient will have access to it, because what you want to avoid are issues around patients not wanting to take their medication, or not being able to afford it; so essentially it’s now part of the transition process.

About the Coagulation Center

The Coagulation Center is an educational resource for healthcare professionals. Guided by a global editorial board of experts, the Coagulation Center offers a range of clinical perspectives on balancing the benefit and risk of anticoagulation in a rapidly changing landscape. Within the Coagulation Center you will find roundtable discussions on anticoagulation management, materials for patient management including patient case studies, tools to help evaluate bleeding risk and stroke risk, and downloadable resources for your practice.