We continue to see patients diagnosed with conditions that require anticoagulation and/or antiplatelet medications. Conditions like coronary artery disease, stroke, non-valvular atrial fibrillation, new or recurrent venous thromboembolism, and mechanical heart valves frequently require lifelong use of these medications. And in 2019, we have more options than ever before! In addition to aspirin, warfarin, and unfractionated heparin, we now have more than four FDA approved target-specific oral anticoagulants (TSOACs). Patients also take a multitude of supplements, some of which can affect bleeding times.
Despite taking “blood thinners” daily, these patients still must undergo common procedures and surgeries. The multitude of these medications affect bleeding time, when should a provider advise a patient to stop them? Proceduralists frequently will expect the patient’s primary care provider to perform a preoperative evaluation or at least advise the patient when to hold their medications, if at all. Where can providers quickly find this information? One option for non-valvular atrial fibrillation is the outstanding American College of Cardiology’s Anticoag Evaluator. Another excellent option for non-valvular atrial fibrillation (and some general information on all anticoagulants) is the excellent MAQI2 Anticoagulation Toolkit from the University of Michigan. The CDC created an app that covers an even wider gamut of medical conditions requiring anticoagulation including VTE, fetal loss, HIT, and arterial thrombosis, in addition to atrial fibrillation called the CDC Anticoagulation Manager.
Anticoagulation Guidelines is a new app from Laurel Ridge Software designed for residents and fellows of a pain medicine physician. Cheryl Bernstein, MD, attempts to simplify this information even further with a reference app that provides the time to stop an anticoagulation/antiplatelet medicine — and not much else. The app is actually written by an ophthalmologist who created the Laurel Ridge Opioid Tool app.
Laurel Ridge Software’s Anticoagulation Guidelines is a bit of a misnomer. The shortened name on an iOS device is CoagStop and that is more appropriate since that is all this app does. For some, this is perfect: select the anticoagulant/antiplatelet and the app tells you when to stop the medication prior to a procedure. However, for most primary care providers we will want more information about the patient, medication, and procedure and not just the number of days/hours to stop a medication. The app may be too simple for its own good with no links, references, or even instructions.
- Simple interface rapidly provides time to stop/hold anticoagulation medications
- Comprehensive list of medications and supplements that can cause bleeding
- App proceduralist/pain medicine specialist focused
- Lacks information on medications, indications, when to restart, etc.
- No references, links, instructions on use
- Not available for Android
Disclaimer: The views expressed are those of the author(s) and do not reflect the official policy of the Department of the Army, the Department of Defense or the U.S. Government.
This post appeared on iMedicalApps.com.