{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T22:49:48Z","timestamp":1790894988566,"version":"4.1.0"},"reference-count":23,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"18","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,9,17]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Direct oral anticoagulants (DOACs) have complex dosing regimens and are often incorrectly prescribed. We evaluated a nationwide DOAC population management dashboard rollout whose purpose includes pharmacist review and correction of off\u2010label dosing prescriptions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">Using data from Veterans Health Affairs, we identified all patients prescribed DOACs for atrial fibrillation or venous thromboembolism between August 2015 and December 2019. Sites were grouped on the basis of the timing of moderate\u2010high usage of the DOAC population management tool dashboard. Effectiveness was defined as the monthly rate of off\u2010label DOAC prescribing and the rate of clinical adverse events (bleeding, composite of stroke or venous thromboembolism). Implementation was evaluated as the percentage of off\u2010label DOAC prescriptions changed within 7\u2009days. Among the 128\u2009652 patients receiving DOAC therapy at 123 centers, between 6.9% and 8.6% had off\u2010label DOAC prescriptions. Adoption of the DOAC population management tool dashboard before July 2018 was associated with a decline in off\u2010label dosing prescriptions (8.7%\u20137.6%). Only 1 group demonstrated a significant reduction in monthly rates of bleeding following implementation. All sites experienced a reduction in the composite of venous thromboembolism or stroke following dashboard adoption. There was no difference in the implementation outcome of DOAC prescription change within 7\u2009days in any of the adoption groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">Early adoption of the DOAC population management tool dashboard was associated with decreased rates of off\u2010label DOAC dosing prescription and reduced bleeding. Following adoption of the DOAC population management tool dashboard, all sites experienced reductions in venous thromboembolism and stroke events.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.124.035859","type":"journal-article","created":{"date-parts":[[2024,9,9]],"date-time":"2024-09-09T07:18:50Z","timestamp":1725866330000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":16,"title":["Pharmacist Use of a Population Management Dashboard for Safe Anticoagulant Prescribing: Evaluation of a Nationwide Implementation Effort"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6532-8440","authenticated-orcid":false,"given":"Geoffrey D.","family":"Barnes","sequence":"first","affiliation":[{"name":"Frankel Cardiovascular Center University of Michigan Ann Arbor MI"},{"name":"Center for Bioethics and Social Science in Medicine University of Michigan Ann Arbor MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-4353-8785","authenticated-orcid":false,"given":"Charity","family":"Chen","sequence":"additional","affiliation":[{"name":"Center for Clinical Management Research Ann Arbor Veterans Affairs Ann Arbor MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rob","family":"Holleman","sequence":"additional","affiliation":[{"name":"Center for Clinical Management Research Ann Arbor Veterans Affairs Ann Arbor MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4289-1417","authenticated-orcid":false,"given":"Joshua","family":"Errickson","sequence":"additional","affiliation":[{"name":"Center for Statistical Consultation and Research University of Michigan Ann Arbor MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8075-1637","authenticated-orcid":false,"given":"F. Jacob","family":"Seagull","sequence":"additional","affiliation":[{"name":"Center for Bioethics and Social Science in Medicine University of Michigan Ann Arbor MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2910-1879","authenticated-orcid":false,"given":"Michael P.","family":"Dorsch","sequence":"additional","affiliation":[{"name":"Frankel Cardiovascular Center University of Michigan Ann Arbor MI"},{"name":"College of Pharmacy University of Michigan Ann Arbor MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0508-1183","authenticated-orcid":false,"given":"Arthur L.","family":"Allen","sequence":"additional","affiliation":[{"name":"Veterans Affairs Salt Lake City Health Care System Salt Lake City UT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5617-1496","authenticated-orcid":false,"given":"Patrick","family":"Spoutz","sequence":"additional","affiliation":[{"name":"Pharmacy Benefits Management Veterans Integrates Service Network 20 Vancouver WA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2158-3618","authenticated-orcid":false,"given":"Jeremy B.","family":"Sussman","sequence":"additional","affiliation":[{"name":"Center for Clinical Management Research Ann Arbor Veterans Affairs Ann Arbor MI"},{"name":"Division of General Medicine University of Michigan Ann Arbor MI"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-021-03212-y"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.07.045"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2016.09.966"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.121.007971"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.13844"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.thromres.2023.03.010"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.37288"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-020-05904-0"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.121.022758"},{"key":"e_1_3_1_11_2","first-page":"e009256","article-title":"Nationwide implementation of a population management dashboard for monitoring direct oral anticoagulants: insights from the veterans affairs health system","author":"Dorsch MP","year":"2022","unstructured":"Dorsch MP, Chen CS, Allen AL, Sales AE, Seagull FJ, Spoutz P, Sussman JB, Barnes GD. Nationwide implementation of a population management dashboard for monitoring direct oral anticoagulants: insights from the veterans affairs health system. 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