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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 2 of 2 Research Studies DisplayedDorsch MP, Chen CS, Allen AL
Nationwide implementation of a population management dashboard for monitoring direct oral anticoagulants: Insights from the Veterans Affairs health system.
Although they exhibit a robust efficacy and safety profile, prescribing Direct oral anticoagulants (DOACs) in accordance with evidence-based practices can be difficult due to varying dosage requirements based on factors like indication, renal function, and drug interactions. To assist pharmacists in reviewing anticoagulant prescriptions, the Veterans Health Affairs (VHA) created and deployed a population management dashboard that displays information on DOACs, prescribed dosages, renal function, age, weight, potential drug interactions, and refill needs. This dashboard operates as a standalone system. The purpose of this study was to assess the DOAC dashboard using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework, analyzing login data from the dashboard. The study found that from August 2016 to June 2020, 150 out of 164 VHA sites utilized the dashboard, with an average of 1875 patients per site. The dashboard was introduced to sites in a staggered manner. Moderate or high adoption, defined as logging in on at least two separate days per month, started slowly with 3 out of 5 pilot sites but quickly rose to 142 out of 150 (94.7%) sites by June 2020. The mean number of unique users per site grew from 2.4 to 7.5 during the study. By the end of the research period, 126 out of 150 (84.0%) sites maintained moderate to high adoption of the dashboard for over six months. The researchers concluded that the population health dashboard for evidence-based anticoagulant prescribing witnessed rapid and sustained implementation and adoption across the national VHA health system in the United States. Investigating the tool's impact on clinical outcomes and replicating this care model in other healthcare systems would be crucial for widespread dissemination and adoption.
AHRQ-funded; HS026874.
Citation: Dorsch MP, Chen CS, Allen AL .
Nationwide implementation of a population management dashboard for monitoring direct oral anticoagulants: Insights from the Veterans Affairs health system.
Circ Cardiovasc Qual Outcomes 2023 Feb; 16(2):e009256. doi: 10.1161/circoutcomes.122.009256..
Keywords: Blood Thinners, Medication, Implementation
Vaughan Sarrazin MS, Jones M, Mazur A
Bleeding rates in Veterans Affairs patients with atrial fibrillation who switch from warfarin to dabigatran.
This study evaluated the relative risks of any, gastrointestinal, intracranial, and other bleeding for Veterans Affairs patients who switched to dabigatran after at least 6 months on warfarin. It found that among veterans with atrial fibrillation who switched to dabigatran, dabigatran increased the risk of gastrointestinal hemorrhage by 54% and was not associated with rates of other bleeding or death.
AHRQ-funded; HS021992
Citation: Vaughan Sarrazin MS, Jones M, Mazur A .
Bleeding rates in Veterans Affairs patients with atrial fibrillation who switch from warfarin to dabigatran.
Am J Med. 2014 Dec;127(12):1179-85. doi: 10.1016/j.amjmed.2014.07.024..
Keywords: Blood Thinners, Adverse Events, Patient Safety