Implementing Prescriber-Pharmacist Collaborative Care for Evidence-based Anticoagulant Use

Existing-prescription notification conditions = Prescriber notification & Pharmacist notification

The number of notifications (in the existing-prescription notification conditions) that are addressed within 7 days/ total number of notifications

Newly prescribed DOAC alert conditions= Medication alert & Medication alert + referral

Data reported represents the number of alerts (in the newly prescribed DOAC alert conditions) that are addressed within 7 days/ total number of alerts

Reported on at the institution level (not individual level). Existing-prescription notification conditions = Prescriber notification & Pharmacist notification

The number of notifications (in the existing-prescription notification conditions) that are addressed within 7 days/ total number of notifications, shown over multiple time periods.

This outcome measure analysis is based on the results of outcome #1.

Reported on at the institution level (not individual level). Newly prescribed DOAC alert condition= Medication alert & Medication alert + referral

The number of new prescription alerts that are addressed within 7 days/ total number of alerts, shown over multiple time periods.

This outcome measure analysis is based on the results of outcome #2.

Data was gathered from the patients of participants within 30 days of a notification being sent via post-hoc examination of electronic medical record data

Clinical adverse events assessed will include major 21 and clinically-relevant non-major bleeding (CRNMB)22 events, as defined by the International Society on Thrombosis and Haemostasis (ISTH), new or recurrent VTE events, and stroke or systemic arterial embolic events. Each of these events will be captured using health informatics tools (described below) and independently adjudicated by two expert clinicians (one pharmacist, one prescriber) who meet once in Y1 and twice in Y2 to adjudicate any potential adverse events. We will use two Michigan Medicine-developed health informatics tools, DataDirect and EMERSE,23 to identify adverse events and capture clinical data (e.g., notes, labs, imaging, procedure reports) for adjudication.