Ardens has created a variety of resources to assist with identifying patients who may need anticoagulants, and to support their ongoing management. The following support article will outline the resources available.
Recording Information on the Management of Patients Prescribed Anticoagulants
The Ardens ‘Anticoagulation' clinical template has been designed to standardise consultations, ensuring clinicians are following the latest national guidelines and recording accurate coding of data.
To locate the Ardens Anticoagulation Template, access the relevant patient record. Open a new consultation and select the Run Template option (if not in consultations, click on the Add button on the EMIS ribbon, followed by Data Using Template option).
This will open the Template Picker screen. If you have accessed any templates before, these will display to the left of the screen. Search for the template by typing “anticoag” in the search box provided:
This will return the Anticoagulation (warfarin, DOAC) template (alternatively select the Ardens > Consultations templates > Pharmacy folder to the right of the screen).
All the Ardens Templates follow the latest NICE guidance and best practice information. Any information displayed in red relates to payment purposes such as QOF, Network DES or local payment. Please note - if the information is relevant for the current financial year, you do not need to duplicate this information.
The template includes a Background page, providing information around the main types of anticoagulants and the reason for use.
The Indication for anticoagulation page enables the clinician to record the reason the anticoagulant is prescribed and for the recording of the patients BP and pulse.
The NCD – Anticoagulant safety page displays the Network Contract DES requirements for the Structured Medication review indicators and the Risk assessment page enables the user to calculate the CHA2DS2-Vasc Risk Score and ORBIT bleeding score.
There are further pages to record details around initiation and monitoring of both Warfarin and DOAC. Both monitoring pages provide sections to record a future diary date for the next review, this will trigger the Ardens Diary Recall System. For more information, please see the following support article.
Within the Resources page there are helpful links for information for patients and links to BNF websites for clinicians.
If anticoagulation is indicated for AF, you may also wish to refer to the Ardens Atrial Fibrillation template or Deep Vein Thrombosis & Superficial Thrombophlebitis (Ardens) template.
Ardens Clinical Safety Alerts
The Ardens resources includes Clinical Safety alerts to flag important MHRA drug safety and NICE guidance information that may be missed. The alerts are triggered on certain activity in the patient record e.g., entering a particular code or prescribing specific drugs.
The following clinical safety alert will be triggered if issuing DOAC to a patient with both antiphospholipid syndrome and thromboembolic disease:
You will be presented with this alert when issuing miconazole if the patient has recently been prescribed warfarin:
Ardens has developed a comprehensive suite of searches, the following searches may be useful to support with the care of your patients on anticoagulants:
- Medication Related Searches – includes an Anticoagulants search folder which identifies DOAC patients and those that require bloods and/or weights prior to reviews. Including searches to identify where clinicians may wish to consider increasing, reducing or stopping medication based on the patient's medication dose.
- Prescribing Monitoring Searches - contains searches to assist practices with drug monitoring to ensure the correct tests are completed. It includes medications such as ACE inhibitors, levothyroxine, anticoagulants, DMARDs and more.
- Miscellaneous Review Searches – includes a search displaying patients with Atrial Fibrillation where a CHA2DS2-VASc score is required.
- Ardens Condition Reports - contains a Cardiovascular folder. Within this folder, the Alerts folder contains some searches regarding anticoagulants and the Case Finders folder displays patients on anticoagulants but with no related diagnosis recorded.
- Network Contract DES Searches – contains the IIF folder, searches within the Cardiovascular and Structured Medication Review folders contain searches relevant anticoagulant searches.
If you require any further assistance on the process above, please contact Ardens support on: firstname.lastname@example.org