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. 2019 May 15;41(4):1012–1020. doi: 10.1007/s11096-019-00844-0

Table 3.

Top 5 interprofessional guideline recommendations to support patients receiving oral anticoagulation therapy

Main recommendation
1. INR-monitoring In patients using VKAs, the international normalized ratio (INR) should be monitored regularly to ensure the safety and effectiveness of oral anticoagulation therapy (OAT)
2. Transfer of care between health care settings Accurate information about patients’ OAT, including current medications, should be transferred accurately between different health care settings to ensure seamless care
3. Adherence to medication In patients using oral anticoagulation medication, adherence to and persistence with therapy should be assessed and supported. Patients and their caregivers should be educated on adherence
4. Patient communication and engagement Communication with and the involvement of patients and their caregivers should be considered an integral component of safe and effective interprofessional OAT-care
5. Medication reconciliation and medication review In OAT-patients, medication reconciliation and medication review should be performed on a regular basis to ensure the safe, effective, and clinically appropriate use of medication