Anticoagulation

Expert Anticoagulation Management—Safer, Easier, and More Accessible

Managing anticoagulation therapy can be complex. Intermountain Health’s Virtual Anticoagulation Specialty Care (VASC) is designed to make it safer, easier, and more accessible for adults who need ongoing anticoagulation in outpatient settings.

• Specialized Team: Care is delivered by pharmacists and advanced practice providers (APPs) with advanced training in anticoagulation best practices and treatment protocols.
• Virtual & In-Person Options: Choose the care model that fits your needs—virtual visits, in-person appointments, or a combination.
• Seamless Collaboration: VASC works closely with your primary care provider to ensure continuity and safety.
• Remote Monitoring: Eligible patients can monitor their INR levels from home, improving convenience and adherence.
• Comprehensive Support: Access to clinical decision support, remote monitoring, and 24/7 on-call care for urgent issues.
• Consistent Best Practices: Standardized protocols reduce care variation, improve outcomes, and lower complication rates.
• Integrated Documentation: All care is documented in your electronic health record for transparency and coordination. 

• Management of warfarin and direct oral anticoagulants (DOACs) such as apixaban and rivaroxaban
• Routine INR monitoring and dose adjustments
• Initiation and transition of anticoagulation therapy
• Periprocedural anticoagulation management
• Anticoagulant selection and duration recommendations
• Patient and caregiver education
• Support for care transitions and complex cases  

Warfarin (brand name Coumadin) is a powerful anticoagulant used to prevent blood clots. However, it requires careful monitoring for several reasons:

• Narrow Therapeutic Window: The difference between an effective dose and a harmful dose is small. Too little warfarin may not prevent clots; too much can cause dangerous bleeding.
• INR Variability: Warfarin’s effect is measured by the International Normalized Ratio (INR). INR can fluctuate due to diet, illness, medications, and other factors, so regular blood tests are essential.
• Drug and Food Interactions: Many foods (especially those high in vitamin K) and medications can alter warfarin’s effectiveness, making dose adjustments necessary.
• Individual Response: Each patient metabolizes warfarin differently, so dosing must be personalized and frequently reviewed.
• Risk of Complications: Without close monitoring, patients are at increased risk for stroke, bleeding, or other serious complications.

VASC’s combination of virtual and in-person care, remote INR monitoring, and expert oversight helps patients stay safe and achieve the best possible outcomes.