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Anticoagulation: Updated Guidelines for Outpatient Management - American Family Physician

Oct 1, 2019 - Anticoagulation therapy is recommended for preventing, treating, and reducing the recurrence of venous thromboembolism, and preventing stroke in persons with atrial fibrillation. Direct oral anticoagulants are first-line agents for eligible patients for treating venous thromboembolism ...

American Family Physician : Article

https://www.aafp.org/afp/2019/1001/p426.html

Updated Guidelines on Outpatient Anticoagulation - American Family Physician

Apr 15, 2013 - The American College of Chest Physicians provides recommendations for the use of anticoagulant medications for several indications that are important in the primary care setting. Warfarin, a vitamin K antagonist, is recommended for the treatment of venous thromboembolism and for the ...

American Family Physician : Article

https://www.aafp.org/afp/2013/0415/p556.html

Epistaxis: Outpatient Management - American Family Physician

Aug 15, 2018 - Epistaxis is a common emergency encountered by primary care physicians. Up to 60% of the general population experience epistaxis, and 6% seek medical attention for it. More than 90% of cases arise from the anterior nasal circulation, and most treatments can be easily performed in the ...

American Family Physician : Article

https://www.aafp.org/afp/2018/0815/p240.html

Management of Sickle Cell Disease: Recommendations from the 2014 Expert Panel Report - ...

Dec 15, 2015 - Family physicians are the primary and sometimes only health care resource for families affected by sickle cell disease. Recently published guidelines provide important recommendations for health maintenance, acute care, and monitoring of disease-modifying therapy in persons with this ...

American Family Physician : Article

https://www.aafp.org/afp/2015/1215/p1069.html

High-Dose vs. Standard-Dose Heparin for VTE Prophylaxis in Obese Patients - FPIN's Help...

Jun 1, 2018 - In most patients weighing more than 220 lb (100 kg), high-dose heparin prophylaxis (7,500 units subcutaneously three times per day) does not further reduce the risk of VTE compared with standard-dose heparin (5,000 units subcutaneously two or three times per day).

American Family Physician : FPIN's Help Desk Answers

https://www.aafp.org/afp/2018/0601/od2.html

Effectiveness and Safety of Factor Xa Inhibitors in Patients with Atrial Fibrillation -...

Oct 1, 2019 - Treatment of AFib with a factor Xa inhibitor results in a decrease in the combined end point of stroke and embolic events (odds ratio [OR] = 0.89; 95% CI, 0.82 to 0.97), as well as a decrease in intracranial hemorrhage (OR = 0.50; 95% CI, 0.42 to 0.59) and all-cause mortality (OR = ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/1001/p405.html

Pneumatic Compression in Addition to Pharmacologic Thromboprophylaxis Does Not Further ...

Oct 1, 2019 - This study found no benefit to the addition of intermittent pneumatic compression to pharmacologic anticoagulation for the prevention of proximal DVT in critically ill patients.

American Family Physician : POEMs

https://www.aafp.org/afp/2019/1001/p440a.html

Bridging Warfarin Before Colonoscopy in Patients with Atrial Fibrillation - FPIN's ...

Apr 15, 2019 - A limited number of trials that examined the risk of temporary interruption of anticoagulation before a variety of procedures did not find a reduction in the risk of stroke, but they did show an increased risk of bleeding events and venous thromboembolism (VTE) in patients who were ...

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2019/0415/p519.html

Anticoagulation for the Long-term Treatment of VTE in Patients with Cancer - Cochrane ...

Jun 1, 2019 - Low-molecular-weight heparin (LMWH), vitamin K antagonists, and direct oral anticoagulants, when used to prevent recurrent VTE, have a similar impact on all-cause mortality.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0601/p676.html

Direct Oral Anticoagulants vs. Warfarin to Prevent Stroke and Embolic Events in ...

Apr 1, 2019 - Direct oral anticoagulants are as likely as warfarin to prevent all strokes and systemic embolic events in patients with atrial fibrillation and CKD stage 3. They do not increase the risk of major bleeding events. The evidence remains insufficient to make recommendations for the use of ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2019/0401/p422.html

Deep Venous Thrombosis: Home vs. Inpatient Treatment - Cochrane for Clinicians - ...

Dec 1, 2018 - Patients treated at home with low-molecular-weight heparin (LMWH) have lower rates of recurrent VTE than those treated in a hospital.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2018/1201/p642.html

Outpatient Management of Anticoagulation Therapy - American Family Physician

Apr 1, 2007 - The Seventh American College of Chest Physicians (ACCP) Conference on Antithrombotic and Thrombolytic Therapy provides guidelines for outpatient management of anticoagulation therapy. The ACCP guidelines recommend short-term warfarin therapy, with the goal of maintaining an ...

American Family Physician : Article

https://www.aafp.org/afp/2007/0401/p1031.html

Evaluating Benefits and Harms of Anticoagulation in Patients with Atrial Fibrillation -...

Dec 15, 2018 - In patients with NVAF, anticoagulants decrease the risk of stroke by approximately 60%. However, they also significantly increase the risk of a major bleeding event or intracranial hemorrhage.

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2018/1215/p751.html

Bleeding with Anticoagulants: ACC Releases Expert Consensus Decision Pathway to Guide ...

Jul 1, 2018 - This Expert Consensus Decision Pathway from the American College of Cardiology (ACC) aims to provide physicians with decision-making assistance for managing bleeding events in patients taking anticoagulants.

American Family Physician : Practice Guidelines

https://www.aafp.org/afp/2018/0701/p57.html

Assessing Bleeding Risk in Patients Taking Anticoagulants - Point-of-Care Guides - ...

Oct 1, 2017 - Family physicians are often faced with the dilemma of balancing the benefit of stroke prevention with the risk of major bleeding when deciding on anticoagulation treatment in patients with atrial fibrillation. Over the past 10 years, several decision support tools have been developed ...

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2017/1001/p465.html

Edoxaban (Savaysa) for the Prevention of Thromboembolic Events - STEPS - American ...

Apr 15, 2018 - Edoxaban is an alternative to warfarin and other oral anticoagulants for the prevention of stroke in patients with nonvalvular atrial fibrillation and for the treatment of deep venous thrombosis and pulmonary embolism.

American Family Physician : STEPS

https://www.aafp.org/afp/2018/0415/p529.html

Rivaroxaban vs. Warfarin for Treatment of DVT and PE - FPIN's Clinical Inquiries - ...

Oct 15, 2017 - Rivaroxaban, along with the other factor Xa inhibitors, is as effective as or better in the short term (three months) than warfarin (Coumadin) for preventing recurrent DVT, nonfatal PE, and fatal PE, with no differences in mortality or bleeding events.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2017/1015/p532.html

Idarucizumab (Praxbind) for Dabigatran (Pradaxa) Anticoagulant Reversal - STEPS - ...

Jun 15, 2017 - Idarucizumab is the only anticoagulant reversal agent for dabigatran. Because of its high cost and limited data regarding clinical benefit, therapy should be reserved for patients taking dabigatran who have life-threatening bleeding or are in need of emergency surgery.

American Family Physician : STEPS

https://www.aafp.org/afp/2017/0615/p798.html

Self-Monitoring and Self-Management of Oral Anticoagulation - Cochrane for Clinicians -...

Jun 1, 2017 - In patients taking warfarin (Coumadin) for anticoagulation, there is moderate-quality evidence that both self-monitoring (number needed to treat [NNT] = 100) and self-management (NNT = 53) reduce thromboembolic events, and that self-management reduces all-cause mortality (NNT = 67).

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2017/0601/p700.html

Opportunities to Improve Outcomes in Sickle Cell Disease - American Family Physician

Jul 15, 2006 - Sickle cell disease represents a spectrum of inherited hemoglobin disorders. The pathophysiology involves abnormalities not just in red blood cells but also vascular endothelium, white blood cell function, coagulation, and inflammatory response. Known sequelae of sickle cell disease ...

American Family Physician : Article

https://www.aafp.org/afp/2006/0715/p303.html

Perioperative Bridging Anticoagulation Unhelpful for Invasive Procedures - POEMs - ...

Jan 15, 2016 - Bridging anticoagulation worsens outcomes for patients with atrial fibrillation who undergo an elective invasive procedure, resulting in more episodes of major bleeding and no difference in the rate of stroke or venous thromboembolism.

American Family Physician : POEMs

https://www.aafp.org/afp/2016/0115/p130.html

Real-World Study Finds Lower Mortality and Stroke Risk with Dabigatran, but More GI ...

Sep 15, 2015 - In this well-designed observational study, older patients given an initial prescription of dabigatran had lower all-cause mortality and fewer ischemic and hemorrhagic strokes, but a higher risk of gastrointestinal (GI) bleeding, than a matched group of patients given warfarin.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0915/p529.html

Bridging Anticoagulation in Patients with Atrial Fibrillation Associated with More ...

Sep 1, 2015 - This study provides more evidence that bridging in patients with nonvalvular atrial fibrillation does not improve outcomes, and is actually associated with a higher risk of bleeding complications and cardiovascular events.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0901/p398.html

Thrombolysis for DVT: Has the Time Arrived? - AFP Journal Club - American Family Physician

Apr 1, 2015 - Catheter-directed thrombolysis for proximal DVT is experimental but may be considered in a patient with phlegmasia and resulting compartment syndrome.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2015/0401/p430.html

Optimal Treatment of Acute Venous Thromboembolism - POEMs - American Family Physician

Apr 1, 2015 - This complex network meta-analysis of eight treatment regimens for acute venous thromboembolism found that a combination of unfractionated heparin and vitamin K antagonists is associated with the least effective strategy with the highest risk of recurrent events.

American Family Physician : POEMs

https://www.aafp.org/afp/2015/0401/p492.html

Approach to Vaso-occlussive Crisis in Adults with Sickle Cell Disease - American Family...

Mar 1, 2000 - The vaso-occlusive crisis, or sickle cell crisis, is a common painful complication of sickle cell disease in adolescents and adults. Acute episodes of severe pain (crises) are the primary reason that these patients seek medical care in hospital emergency departments. Frequently, ...

American Family Physician : Article

https://www.aafp.org/afp/2000/0301/p1349.html

New Anticoagulants vs. Warfarin in Atrial Fibrillation: No Clear Winner - POEMs - ...

Jul 15, 2014 - In this meta-analysis, newer anticoagulants appear to be slightly more effective than warfarin in the short term (two years) in preventing strokes of all kinds in patients with atrial fibrillation. However, they are no more effective than warfarin in preventing ischemic strokes, and ...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0715/p110a.html

Fewer Major Bleeds with Edoxaban Than with Warfarin, but Treatment Benefit Unclear - ...

May 15, 2014 - Edoxaban provides similar effectiveness and a somewhat lower rate of major gastrointestinal and intracranial bleeding than warfarin. It is worth reading the supplemental appendices to this report for a look at the subgroups. For almost all subgroups, low-dose edoxaban caused less major ...

American Family Physician : POEMs

https://www.aafp.org/afp/2014/0515/p827.html

Is Rivaroxaban Noninferior to Standard Warfarin Therapy in Preventing Recurrent PE and ...

Jun 15, 2013 - A trial showing that one drug is noninferior to another does not mean that these drugs are equivalent. The noninferiority margin allows researchers to choose their own benchmark for what is considered a clinically significant difference between two drugs.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2013/0615/p872.html

Thromboembolism - Clinical Evidence Handbook - American Family Physician

Jan 15, 2012 - What are the effects of treatments for proximal and isolated calf DVT? What are the effects of treatments for pulmonary embolism? What are the effects of interventions on oral anticoagulation management in persons with thromboembolism?

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2012/0115/p188.html

Low-Molecular Weight Heparin in Preventing and Treating DVT - American Family Physician

Mar 15, 1999 - Low-molecular-weight heparin is a relatively recent addition to the list of therapies for prophylaxis and treatment of deep venous thrombosis (DVT). As a prophylactic, low-molecular-weight heparin is as effective as standard heparin or warfarin and does not require monitoring of the ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0315/p1607.html

Ambulatory Management of Common Forms of Anemia - American Family Physician

Mar 15, 1999 - Anemia is a prevalent condition with a variety of underlying causes. Once the etiology has been established, many forms of anemia can be easily managed by the family physician. Iron deficiency, the most common form of anemia, may be treated orally or, rarely, parenterally. Vitamin B12 ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0315/p1598.html

Low-Molecular-Weight Heparin in Treatment of DVT - American Family Physician

Feb 15, 1999 - Patients with a diagnosis of acute deep venous thrombosis have traditionally been hospitalized and treated with unfractionated heparin followed by oral anticoagulation therapy. Several clinical trials have shown that low-molecular-weight heparin is at least as safe and effective as ...

American Family Physician : Article

https://www.aafp.org/afp/1999/0215/p945.html

Anticoagulation for the Long-term Treatment of VTE in Patients with Cancer - Cochrane ...

Jul 1, 2009 - Although LMWH appears to be more effective than oral anticoagulants in the prevention of recurrent VTE, this does not translate into a survival benefit. LMWH and oral anticoagulants have the same reported adverse events of bleeding and thrombocytopenia.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2009/0701/p30.html

Oral Anticoagulants vs. Antiplatelet Therapy - Cochrane for Clinicians - American ...

May 1, 2008 - Compared with antiplatelet therapy, oral anticoagulation significantly reduces stroke at an average follow-up of one to three years, but does not reduce mortality. Intracranial or extracranial hemorrhage is more common with anticoagulation and must be weighed against its therapeutic ...

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2008/0501/p1250.html

Is Unfractionated Heparin Equivalent to Low-Molecular-Weight Heparin for Venous ...

Jun 1, 2008 - Is weight-based unfractionated heparin as good as weight-based low-molecular-weight heparin for outpatient treatment of venous thromboembolism? Even though this study was underpowered to prove equivalence, treatment with subcutaneous unfractionated heparin is a viable option.

American Family Physician : AFP Journal Club

https://www.aafp.org/afp/2008/0601/p1492.html

Evidence-Based Initiation of Warfarin (Coumadin) - Point-of-Care Guides - American ...

Feb 15, 2005 - Many physicians continue to use clinical judgment alone as the basis for initiating and adjusting warfarin dosages in patients who require oral anticoagulation. A number of studies have validated approaches to initiation of anticoagulation that provide more rapid anticoagulation with ...

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2005/0215/p763.html

Evidence-Based Adjustment of Warfarin (Coumadin) Doses - Point-of-Care Guides - ...

May 15, 2005 - A previous Point-of-Care Guides article,1 presented several validated approaches to the initiation of anticoagulation therapy with warfarin. Once a patient is receiving warfarin, it is important to have a systematic approach to the management of anticoagulation and adjustment of ...

American Family Physician : Point-of-Care Guides

https://www.aafp.org/afp/2005/0515/p1979.html

Low-Molecular-Weight Heparin for Initial Treatment of Venous Thromboembolism - Cochrane...

Jul 1, 2005 - LMWH is safer and more effective than unfractionated heparin for initial treatment of venous thromboembolism.

American Family Physician : Cochrane for Clinicians

https://www.aafp.org/afp/2005/0701/p75.html

Treatment of Calf Deep Venous Thrombosis - FPIN's Clinical Inquiries - American Family ...

Jun 1, 2005 - Patients with a first episode of calf DVT with a transient risk factor should receive heparin therapy followed by oral anticoagulation for six to 12 weeks.

American Family Physician : FPIN's Clinical Inquiries

https://www.aafp.org/afp/2005/0601/p2157.html

Thromboembolism - Clinical Evidence Handbook - American Family Physician

Jan 1, 2004 - What are the effects of treatments for proximal deep venous thrombosis? What are the effects of treatments for isolated calf venous thrombosis? What are the effects of treatments for pulmonary embolism? What are the effects of computerized decision support on oral anticoagulation ...

American Family Physician : Clinical Evidence Handbook

https://www.aafp.org/afp/2004/0101/p132.html

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