• Tiina Tiihonen
  • 24.11.2022

Monitoring of direct oral anticoagulants as part of good care

The new generation of direct oral anticoagulants has partly replaced warfarin treatments. Even though the mechanism of action of direct oral anticoagulants differs slightly, their effectiveness should be regularly measured. High-quality monitoring is also essential for proper patient care.

According to Lääkärilehti 10/21 (”Suomalaisten eteisvärinäpotilaiden kokemuksia sairautensa hoidosta”, eng. “Finnish atrial fibrillation patients’ experiences of their illness”, Hekkala), up to one in three blood-thinning therapy patients have dropped out of follow-up. While direct oral anticoagulants may be a better option for some patients compared to warfarin, they also require monitoring. The risks of anticoagulant therapy, such as anemia or kidney problems, are more pronounced in older individuals. Properly managing these risks includes monitoring treatment balance and response.

Assessing the effectiveness of medication is crucial for several reasons. When patients are active participants in their treatment, they have the right to know what’s happening in their bodies. Regular assessment of medication response is also vital for treatment adherence. When the patient becomes an active participant in the treatment process, the medication feels more personalized. Regularity is crucial in direct oral anticoagulant therapy, as even a missed dose significantly reduces the treatment’s effectiveness.

The European Society of Cardiology (ESC) recommends blood testing approximately every four months for users of direct oral anticoagulants over 75 years old, particularly for dabigatran users. Other users of direct oral anticoagulants are advised to undergo annual monitoring. Even with direct oral anticoagulants, leaving monitoring solely to the patient increases the risk of serious complications.

Medication is a process between the patient and the physician. It operates on mutual trust, but it also requires information and data about the patient’s medication status to build and maintain that trust. Forsante is part of this chain, acting as an inconspicuous link between the patient and the professional. It sends reminders for lab visits and automatically interprets lab results. Forsante’s technology assesses each sample and alerts if the situation is abnormal. This ensures high-quality monitoring, even for users of direct oral anticoagulants.