Health Care Providers (HCPs)

DEEP VEIN THROMBOSIS

Outpatient DVT Follow-Up Protocol

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  All Patients Warfarin Apixaban Rivaroxaban Dabigatran/Edoxaban 
Day 1-2:

Nursing or Anticoagulation Clinic Phone Call
  • Ensure patient has obtained prescription
  • Assess for bleeding complications, recurrent/progressive thrombotic symptoms
  • Ensure dosing is appropriate for renal function (checked at time of DVT diagnosis)
        
Day 5:

Nursing or Anticoagulation Clinic Follow Up

 Assess medication adherance, bleeding complications, recurrent/ progressive thrombotic symptoms, scheduled procedures, concomitant medications Check INR, when 2-3 can discontinue LMWH

 

 Ensure dosing change after Day 7 (10 mg BID → 5 mg BID)  Switch from LMWH to Dabigatran or Edoxaban
Day 21:

Nursing or Anticoagulation Clinic Phone Call

 

 Assess medication compliance, bleeding complications, recurrent/ progressive thrombotic symptoms, scheduled procedures, concomitant medications      Ensure dose change after Day 21 (15 mg BID → 20 mg daily)
3 months:

Clinic Visit
  • Assess medication compliance, bleeding complications, recurrent/ progressive thrombotic symptoms, scheduled procedures, concomitant medications
  • Re-assess length of treatment (3 months vs. indefinite)
  • Patients with Cockcroft-Gault CrCl 30-50 mL/min, repeat renal function testing

 

        
6 months: 

Nursing or Anticoagulation Clinic Phone Call
  • Assess medication compliance, bleeding complications, recurrent/ progressive thrombotic symptoms, scheduled procedures, concomitant medications
  • Patients with Cockcroft-Gault CrCl 30-75 mL/min, repeat renal function testing

 

        
9 months:

Nursing or Anticoagulation Clinic Phone Call

 
  • Assess medication compliance, bleeding complications, recurrent/ progressive thrombotic symptoms
  • Patients with Cockcroft-Gault CrCl 30-50 mL/min, repeat renal function testing

 

        
1 year:

Clinic Visit

 
  • Assess medication compliance, bleeding complications, recurrent/ progressive thrombotic symptoms
  • Repeat renal function testing

 

        

References: FDA prescribing documents (www.fda.gov)
Europace. 2015 Oct;17 (10):1467-507
www.anticoagulationtoolkit.org

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