IPRO Coalition Develops Clinical Tool

A new, free-of-charge tool designed by the IPRO-led New York State Anticoagulation Coalition will enable clinicians to more easily determine how, whether and when to stop the use of warfarin and other anticoagulants prior to surgery and interventional procedures. Creators of this unique tool, known as “MAP” (Managing Anticoagulation in the Peri-Procedural Period), believe it is the first time evidence-based guidelines on this critical topic have been distilled into an easy-to-use, single-page format. The Task Force reviewed hundreds of pages of medical journal articles to create this unique reference tool. Organized in a series of grids, the MAP tool gives multiple scenarios related to the use of anticoagulant medications, including levels of patient thrombosis (blood clot) risk and categories of bleeding risk. The reference guide can be downloaded from IPRO’s website and printed on a single sheet of 11”x17” paper to provide clear guidance on how each individual case should be handled. “While the medical literature contains expert guidance for the use of anticoagulants during invasive procedures, to our knowledge there has never been a simplified reference guide to anticoagulant use that clinicians can quickly refer to when planning these procedures,” said Clare B. Bradley MD, MPH, Senior Vice President and Chief Medical Officer, IPRO. “Our task force saw this need, and developed this useful tool.” Surgery and invasive medical interventions increase the risk of bleeding, but withholding anticoagulants increases the risk of thrombosis due to the underlying conditions for which anticoagulation was originally prescribed. The MAP tool helps clinicians guide their decision making in balancing these risks, and enables them to make more informed choices on whether to interrupt oral anticoagulation for a medical procedure. The tool also provides guidance on, if anticoagulation is interrupted, whether to “bridge” with injectable anticoagulants, such as low molecular weight heparin in patients who are normally treated with warfarin. Although just launched, the MAP tool has already been reviewed by the Anticoagulation Forum, the leading organization of anticoagulation professionals, and has been added to their “Anticoagulation Centers of Excellence” page, for use by member anticoagulation specialists across the United States. To download a copy of the MAP tool, go to: http://qio.ipro.org/drug-safety/drug-safety-resources.