{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,19]],"date-time":"2025-11-19T14:59:15Z","timestamp":1763564355766,"version":"3.41.0"},"reference-count":26,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,7,3]],"date-time":"2024-07-03T00:00:00Z","timestamp":1719964800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Clin Pharmacol"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:sec><jats:title>Aims<\/jats:title><jats:p>The management of patients treated with direct oral anticoagulants (DOACs) during hospitalization is a common challenge in clinical practice. Although bridging is generally not recommended, too often DOACs are switched to parenteral therapy with low molecular weight heparins. Our objectives were to update a local guideline for perioperative DOAC management and to develop a guideline for the anticoagulation management in non\u2010surgical patients regarding temporary DOAC discontinuation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We executed a two\u2010step modified Delphi study in a 1000\u2010bed university hospital in Belgium. The Delphi questionnaires were developed based on a literature review and a telephone survey of prescribers. Two expert panels were established: one dedicated to perioperative DOAC management and the other to DOAC management in non\u2010surgical patients. Both panels completed two rounds, commencing with an individual and online round, followed by a face\u2010to\u2010face group session.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After the two\u2010round Delphi process, the updated perioperative guideline on DOAC management included reasons for delaying the resumption of DOACs following surgery, such as oral intake not possible, the probability of re\u2010intervention within 3\u2009days, and insufficient haemostasis (e.g. active clinically significant haematoma, haemorrhagic drains or wounds). Furthermore, a guideline for non\u2010surgical hospitalized patients was developed, outlining possible reasons for interrupting DOAC therapy. Both guidelines offer clear anticoagulation therapy strategies corresponding to the identified scenarios.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We have updated and developed guidelines for DOAC management in surgical and non\u2010surgical patients during hospitalization, which aim to support prescribers and to enhance targeted prescription review by hospital pharmacists.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bcp.16159","type":"journal-article","created":{"date-parts":[[2024,7,3]],"date-time":"2024-07-03T09:00:08Z","timestamp":1719997208000},"page":"2673-2683","source":"Crossref","is-referenced-by-count":1,"title":["Optimizing anticoagulation therapy for in\u2010hospital patients on direct oral anticoagulants: a single\u2010centre modified Delphi study"],"prefix":"10.1111","volume":"90","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2458-5237","authenticated-orcid":false,"given":"Andreas","family":"Capiau","sequence":"first","affiliation":[{"name":"Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences Ghent University  Ghent Belgium"},{"name":"Department of Pharmacy Ghent University Hospital  Ghent Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justine","family":"De Vleeschauwer","sequence":"additional","affiliation":[{"name":"Department of Pharmacy Ghent University Hospital  Ghent Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tine","family":"De Backer","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Heart Centre Ghent University Hospital  Ghent Belgium"},{"name":"Department of Internal Medicine and Paediatrics, Faculty of Medicine and Health Sciences Ghent University  Ghent Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sofie","family":"Gevaert","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Heart Centre Ghent University Hospital  Ghent Belgium"},{"name":"Department of Internal Medicine and Paediatrics, Faculty of Medicine and Health Sciences Ghent University  Ghent Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Caren","family":"Randon","sequence":"additional","affiliation":[{"name":"Department of Thoracic and Vascular Surgery Ghent University Hospital  Ghent Belgium"},{"name":"Department of Human Structure and Repair, Faculty of Medicine and Health Sciences Ghent University  Ghent Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1848-208X","authenticated-orcid":false,"given":"Els","family":"Mehuys","sequence":"additional","affiliation":[{"name":"Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences Ghent University  Ghent Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koen","family":"Boussery","sequence":"additional","affiliation":[{"name":"Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences Ghent University  Ghent Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Annemie","family":"Somers","sequence":"additional","affiliation":[{"name":"Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences Ghent University  Ghent Belgium"},{"name":"Department of Pharmacy Ghent University Hospital  Ghent Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2024,7,3]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa612"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2021.07.055"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euab303"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euab065"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/s0140\u20106736(13)62343\u20100"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/eht557"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.13305"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehac270"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1161\/cir.0000000000000477"},{"volume-title":"Perioperative management of patients receiving anticoagulants. 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