{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T18:04:56Z","timestamp":1784311496792,"version":"3.55.0"},"reference-count":40,"publisher":"Public Library of Science (PLoS)","issue":"7","license":[{"start":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:00:00Z","timestamp":1784246400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>Anticoagulants are crucial for both the immediate and ongoing management of thromboembolic disorders, including atrial fibrillation and venous thromboembolism, and for patients with mechanical heart valves. However, their management during the periprocedural period requires carefully balancing thromboembolic and bleeding risks, underscoring the need for coordinated and structured periprocedural anticoagulation management (PAM). Pharmacists, with their comprehensive training and expertise in medication management, are well positioned to deliver PAM. However, empirical evidence related to the roles of Canadian pharmacists in PAM, or the barriers, facilitators, and organizational structures that shape their practice is lacking. This protocol paper outlines a qualitative study that uses a qualitative description design grounded in constructionism and naturalism. The study aims to provide an in-depth understanding of pharmacists\u2019 roles and experiences in PAM across Canada, while exploring variations by demographic and practice characteristics. Using purposeful maximum variation sampling, licensed Canadian pharmacists with at least 6 months of current PAM experience will be recruited to take part in one semi-structured interview conducted virtually using Microsoft Teams. Interviews will be recorded and transcribed verbatim and analyzed using conventional qualitative content analysis to inductively generate codes and categories. The findings of this research will address gaps in the literature by providing a detailed description of pharmacists\u2019 roles in PAM and the contextual factors influencing practice across diverse regions and settings in Canada. Findings may inform future PAM service models, professional training, and health system policies to support optimal care coordination and improved patient outcomes in the Canadian anticoagulation care landscape.<\/jats:p>","DOI":"10.1371\/journal.pone.0353786","type":"journal-article","created":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T17:43:28Z","timestamp":1784310208000},"page":"e0353786","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["The pharmacist\u2019s role in the periprocedural management of anticoagulation in Canada: A qualitative study protocol"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-9132-7305","authenticated-orcid":true,"given":"Chioma S.","family":"Okpalaora","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie W.","family":"Young","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5207-2186","authenticated-orcid":true,"given":"Tiffany A.","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,7,17]]},"reference":[{"issue":"20","key":"pone.0353786.ref001","doi-asserted-by":"crossref","first-page":"3214","DOI":"10.3390\/cells11203214","article-title":"Anticoagulants: A Short History, Their Mechanism of Action, Pharmacology, and Indications","volume":"11","author":"M Heestermans","year":"2022","journal-title":"Cells"},{"key":"pone.0353786.ref002","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1016\/j.jacc.2016.11.024","article-title":"ACC expert consensus decision pathway for periprocedural management of anticoagulation in patients with nonvalvular atrial fibrillation","volume":"69","author":"JU Doherty","year":"2017","journal-title":"J Am Coll Cardiol"},{"issue":"5","key":"pone.0353786.ref003","doi-asserted-by":"crossref","DOI":"10.1016\/j.chest.2022.07.025","article-title":"Perioperative Management of Antithrombotic Therapy: An American College of Chest Physicians Clinical Practice Guideline","volume":"162","author":"JD Douketis","year":"2022","journal-title":"Chest"},{"issue":"6","key":"pone.0353786.ref004","doi-asserted-by":"crossref","first-page":"600","DOI":"10.1016\/j.pcad.2018.03.002","article-title":"Peri-Procedural Management of Oral Anticoagulants in the DOAC Era","volume":"60","author":"GD Barnes","year":"2018","journal-title":"Prog Cardiovasc Dis"},{"key":"pone.0353786.ref005","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1007\/978-3-319-22602-6_8","article-title":"Peri-procedural Anticoagulation.","volume-title":"Anticoagulation Management: A Guidebook for Pharmacists","author":"M. Barras","year":"2015"},{"issue":"2","key":"pone.0353786.ref006","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1161\/CIRCOUTCOMES.115.002366","article-title":"Reimagining Anticoagulation Clinics in the Era of Direct Oral Anticoagulants","volume":"9","author":"GD Barnes","year":"2016","journal-title":"Circ Cardiovasc Qual Outcomes"},{"key":"pone.0353786.ref007","doi-asserted-by":"crossref","DOI":"10.2146\/ajhp160726","article-title":"Impact of educational intervention on management of periprocedural anticoagulation","volume":"74","author":"AL Awker","year":"2017","journal-title":"Am J Health Syst Pharm"},{"issue":"5","key":"pone.0353786.ref008","article-title":"Improving preprocedure antithrombotic management: Implementation and sustainment of a best practice alert and pharmacist referral process","volume":"5","author":"H Han","year":"2021","journal-title":"Res Pract Thromb Haemost"},{"issue":"12","key":"pone.0353786.ref009","doi-asserted-by":"crossref","first-page":"1156","DOI":"10.1592\/phco.31.12.1156","article-title":"I\u2019m still here: reflections on 39 years of clinical practice in a community hospital-based anticoagulation service","volume":"31","author":"TS Sisca","year":"2011","journal-title":"Pharmacotherapy"},{"key":"pone.0353786.ref010","article-title":"The Kaiser Permanente Colorado Clinical Pharmacy Anticoagulation Service as a model of modern anticoagulant care","author":"DM Witt","year":"2008","journal-title":"Thromb Res"},{"issue":"6","key":"pone.0353786.ref011","doi-asserted-by":"crossref","first-page":"1852","DOI":"10.1007\/s11096-025-01985-1","article-title":"Exploring the role of community pharmacists in perioperative management of antithrombotic agents: a qualitative study of barriers, facilitators, and future directions","volume":"47","author":"A Capiau","year":"2025","journal-title":"Int J Clin Pharm"},{"key":"pone.0353786.ref012","author":"Australasian Pharmacy","year":"2025"},{"issue":"6","key":"pone.0353786.ref013","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1177\/17151635211047528","article-title":"Changes within an anticoagulation clinic during COVID-19","volume":"154","author":"S Selland","year":"2021","journal-title":"Can Pharm J (Ott)"},{"key":"pone.0353786.ref014","first-page":"605","article-title":"Pharmacists as front line clinicians in a new multidisciplinary thrombosis service","volume":"47","author":"S Young","year":"2019","journal-title":"J Thromb Thrombolysis"},{"issue":"3","key":"pone.0353786.ref015","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1111\/jep.12504","article-title":"Evaluation of pharmacist-based compared to doctor-based anticoagulation management in Qatar","volume":"22","author":"H Elewa","year":"2016","journal-title":"J Eval Clin Pract"},{"issue":"7","key":"pone.0353786.ref016","doi-asserted-by":"crossref","first-page":"483","DOI":"10.2146\/ajhp151026","article-title":"Evaluation of a pharmacist-led outpatient direct oral anticoagulant service","volume":"74","author":"E Ashjian","year":"2017","journal-title":"Am J Health Syst Pharm"},{"issue":"1","key":"pone.0353786.ref017","article-title":"Evaluation of a pharmacist-managed anticoagulation clinic: Improving patient care","volume":"3","author":"TJ Bungard","year":"2009","journal-title":"Open Med"},{"issue":"1","key":"pone.0353786.ref018","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1002\/nur.20362","article-title":"What\u2019s in a name? Qualitative description revisited","volume":"33","author":"M Sandelowski","year":"2010","journal-title":"Res Nurs Health"},{"issue":"4","key":"pone.0353786.ref019","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1002\/1098-240X(200008)23:4<334::AID-NUR9>3.0.CO;2-G","article-title":"Whatever happened to qualitative description?","volume":"23","author":"M Sandelowski","year":"2000","journal-title":"Res Nurs Health"},{"key":"pone.0353786.ref020","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1186\/1471-2288-9-52","article-title":"Qualitative description - the poor cousin of health research?","volume":"9","author":"MA Neergaard","year":"2009","journal-title":"BMC Med Res Methodol"},{"key":"pone.0353786.ref021","doi-asserted-by":"crossref","DOI":"10.4324\/9781003335016","volume-title":"Social constructionism","author":"V Burr","year":"2024","edition":"4"},{"key":"pone.0353786.ref022","volume-title":"The SAGE handbook of qualitative research","author":"NK Denzin","year":"2005","edition":"3"},{"issue":"4","key":"pone.0353786.ref023","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1177\/1937586715614171","article-title":"Qualitative Descriptive Methods in Health Science Research","volume":"9","author":"KJ Colorafi","year":"2016","journal-title":"HERD"},{"issue":"4","key":"pone.0353786.ref024","doi-asserted-by":"crossref","first-page":"551","DOI":"10.1089\/jwh.2019.8233","article-title":"Gender Differences in Patient Perceptions of Physicians\u2019 Communal Traits and the Impact on Physician Evaluations","volume":"30","author":"H Chen","year":"2021","journal-title":"J Womens Health (Larchmt)"},{"issue":"5","key":"pone.0353786.ref025","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1037\/0278-6133.13.5.384","article-title":"Gender in medical encounters: an analysis of physician and patient communication in a primary care setting","volume":"13","author":"JA Hall","year":"1994","journal-title":"Health Psychol"},{"issue":"3","key":"pone.0353786.ref026","doi-asserted-by":"crossref","DOI":"10.3399\/BJGPO.2024.0158","article-title":"How gender shapes practice choices among family medicine residents and early career family physicians: a Canadian qualitative study","volume":"9","author":"A Sheppard","year":"2025","journal-title":"BJGP Open"},{"key":"pone.0353786.ref027","first-page":"1","article-title":"Accessing hidden and hard-to-reach populations: snowball research strategies","volume":"33","author":"R Atkinson","year":"2001","journal-title":"Soc Res Update"},{"key":"pone.0353786.ref028","volume-title":"Reading research: A user-friendly guide for health professionals","author":"B Davies","year":"2012","edition":"5"},{"issue":"2","key":"pone.0353786.ref029","doi-asserted-by":"crossref","first-page":"179","DOI":"10.1002\/nur.4770180211","article-title":"Sample size in qualitative research","volume":"18","author":"M Sandelowski","year":"1995","journal-title":"Res Nurs Health"},{"key":"pone.0353786.ref030","volume-title":"The SAGE handbook of interview research: The complexity of the craft","author":"J Gubrium","year":"2012","edition":"2"},{"key":"pone.0353786.ref031","doi-asserted-by":"crossref","DOI":"10.4135\/9781036234386","volume-title":"Qualitative Methods for Health Research","author":"J Green","year":"2018","edition":"4"},{"issue":"2","key":"pone.0353786.ref032","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1177\/160940690200100202","article-title":"Verification Strategies for Establishing Reliability and Validity in Qualitative Research","volume":"1","author":"JM Morse","year":"2002","journal-title":"Int J Qual Methods"},{"issue":"9","key":"pone.0353786.ref033","doi-asserted-by":"crossref","first-page":"1277","DOI":"10.1177\/1049732305276687","article-title":"Three approaches to qualitative content analysis","volume":"15","author":"H-F Hsieh","year":"2005","journal-title":"Qual Health Res"},{"issue":"1","key":"pone.0353786.ref034","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1111\/j.1365-2648.2007.04569.x","article-title":"The qualitative content analysis process","volume":"62","author":"S Elo","year":"2008","journal-title":"J Adv Nurs"},{"issue":"42","key":"pone.0353786.ref035","doi-asserted-by":"crossref","first-page":"39","DOI":"10.7748\/ns2001.07.15.42.39.c3052","article-title":"Use of constant comparative analysis in qualitative research","volume":"15","author":"J Hewitt-Taylor","year":"2001","journal-title":"Nurs Stand"},{"issue":"6","key":"pone.0353786.ref036","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1177\/1049732303013006008","article-title":"Within-case and across-case approaches to qualitative data analysis","volume":"13","author":"L Ayres","year":"2003","journal-title":"Qual Health Res"},{"key":"pone.0353786.ref037","doi-asserted-by":"crossref","DOI":"10.1016\/0147-1767(85)90062-8","volume-title":"Naturalistic inquiry","author":"YS Lincoln","year":"1985"},{"issue":"2","key":"pone.0353786.ref038","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1016\/j.nedt.2003.10.001","article-title":"Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness","volume":"24","author":"UH Graneheim","year":"2004","journal-title":"Nurse Educ Today"},{"issue":"6","key":"pone.0353786.ref039","doi-asserted-by":"crossref","first-page":"349","DOI":"10.1093\/intqhc\/mzm042","article-title":"Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups","volume":"19","author":"A Tong","year":"2007","journal-title":"Int J Qual Health Care"},{"issue":"9","key":"pone.0353786.ref040","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1001\/jamasurg.2021.0525","article-title":"SRQR and COREQ Reporting Guidelines for Qualitative Studies","volume":"156","author":"LA Dossett","year":"2021","journal-title":"JAMA Surg"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0353786","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T17:43:33Z","timestamp":1784310213000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0353786"}},"subtitle":[],"editor":[{"given":"Eyob Alemayehu","family":"Gebreyohannes","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,7,17]]},"references-count":40,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7,17]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0353786","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,17]]}}}