2) #Physicians #Nurses #Pharmacists #physicianassociate #NPs earn 0.5h CE/#CME from @academiccme for following this 🧵 pic.twitter.com/kUUr5AQ1yz
— cardio-met (@cardiomet_CE) November 29, 2022
4) From bugs 🦠 to blood 🩸, multidisciplinary clinicians are making an #impact on #patientsafety & building on 25 years of antibiotic stewardship experience to support development &implementation of #ACStewardship programs around the world 🌎
— cardio-met (@cardiomet_CE) November 29, 2022
6) #ACStewardship = coordinated, efficient, sustainable system-level initiatives. Goals:
— cardio-met (@cardiomet_CE) November 29, 2022
👉 Achieve optimal anticoagulant-related health outcomes
👉 Minimize avoidable #AC related adverse drug events #ADEs
8) It’s C, 8⃣%! With ~33 million annual hospital admissions, this equates to 3⃣ million AC-associated INPATIENT 🏥 medication errors each year in the US alone! & this is a concerning pattern that is not isolated to the inpatient setting…
— cardio-met (@cardiomet_CE) November 29, 2022
10) ⬆️#AC RXing + increased ⬆️ inappropriate use = ⬆️ #emergencydepartment #ED visits. How many ED encounters for #ADEs are related to anticoagulation in the 🇺🇸?
— cardio-met (@cardiomet_CE) November 29, 2022
12) Why are #DOAC-associated #ADEs on the rise 📈? Likely culprits: pic.twitter.com/YhmQFezSpy
— cardio-met (@cardiomet_CE) November 29, 2022
14)
— cardio-met (@cardiomet_CE) November 29, 2022
👉Off-label dosing occurs in up to 25% of #DOAC patients and leads to thromboembolic and bleeding events 🩸
👉Peri-op management and drug-drug interactions are often mismanaged by clinicians less familiar with DOAC #PK
16a) Don’t believe us? Here are a few real-life examples of #DOAC-associated #ADEs discovered within our #ACStewardship service just this week pic.twitter.com/nanAfz5qMJ
— cardio-met (@cardiomet_CE) November 29, 2022
16c)
— cardio-met (@cardiomet_CE) November 29, 2022
🩸A patient developed an acute #VTE after being instructed by his surgeon to hold #rivaroxaban 7 days pre-op
16e)
— cardio-met (@cardiomet_CE) November 29, 2022
🩸A patient on apixaban was unnecessarily prescribed rifampin for extended period and returned with new #DVT
⚠️While they don’t require routine laboratory monitoring, #DOACs DO require specialized management!
18) BIG problems need BIG solutions, and the @AnticoagForum has issued an important #CallToAction pic.twitter.com/p6cs1JOn1W
— cardio-met (@cardiomet_CE) November 29, 2022
19b) Also ✔️out the #ACStewardship Implementation Playbook in partnership with the @NatQualityForum (available at 🔓 https://t.co/jWKgpxaUq1 ) pic.twitter.com/1np8PgmTlg
— cardio-met (@cardiomet_CE) November 29, 2022
20b) This paper catalogs published successful #ACStewardship initiatives that can be adopted into YOUR practice & details our vision for needed steps ➡️goal of reg standards or mandates for #ACStewardship programs in all hospitals, similar to the mandate for #ABXstewardship pic.twitter.com/DCjyOmB0Rd
— cardio-met (@cardiomet_CE) November 29, 2022
21b)
— cardio-met (@cardiomet_CE) November 29, 2022
🩸Mercy-Health – St. Anne Hospital: 🔓https://t.co/ytVF5lEpEu describes #pharmacist-led aspirin de-escalation in patients on indefinite anticoagulation
22) AND, they are creating an army of #ACStewards of the future with a new @ASHPofficial approved PGY2 Pharmacy Residency in #Thrombosis & Hemostasis. ✔️out how this advanced specialty training program was developed in @JACCP here at https://t.co/WxkHuWVNfq!
— cardio-met (@cardiomet_CE) November 29, 2022
23b) Congratulations to grant recipients @johnfanikos @BrighamPharmacy, @kdane_pharmd @JohnsHopkins, @MCJPharmD @HenryFordHealth, @anticoagconsult @SanfordHealth and @UNMPharmResi @UNMHospital
— cardio-met (@cardiomet_CE) November 29, 2022
25) But there is more to be done… & we need YOU! pic.twitter.com/3TL31Ewsrw
— cardio-met (@cardiomet_CE) November 29, 2022
26b) and . . .
— cardio-met (@cardiomet_CE) November 29, 2022
✅Be persistent! Advocate to make #ACstewardship programs a national requirement in all patient care settings
27) That's it for now . . . but to claim your 0.5h🆓CE/#CME credit, go to https://t.co/zSIlwJf6Lz and answer two case-based questions! Thanks for joining us, and PLEASE FOLLOW @cardiomet_ce for more 🆓#cardiometabolic education!
— cardio-met (@cardiomet_CE) November 29, 2022