We are aware that many GPs are switching patients on warfarin to directoral anticoagulants (DOACs) to reduce the need for face to face contact with International Normalized Ratio (INR) checks. Whilst the benefits of this are clear in the current COVID-19 crisis it is important that this is undertaken in a safe way and not applied to patients who are unsuitable for DOACs. Whilst awaiting the broader guidance, a number of associations and societies across the UK have come together to provide guidance on the safe switching of warfarin to DOACs. This needs to be undertaken in a phased manner over the 12 week cycle of INR monitoring to protect the supply chain of anticoagulants for ALL patients.
Many patients are not suitable for a switch from warfarin to DOACs and further guidance will be available shortly to support services providing care for these patients. In the meantime please follow this link to the Royal Pharmaceutical Society website to find out more.
Helen Williams, National Specialist Adviser for CVD Prevention at NHS England and Improvement, and Clinical Adviser at UCLPartners (part of the AHSN Network), has produced a guide on how to safely switch patients from warfarin to DOACs. The guide is endorsed by the Royal College of General Practitioners and the British Haematology Society.