# Improving Safe Use of Direct Oral Anticoagulants: A Population Health Approach

> **NIH AHRQ R18** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2021 · $499,545

## Abstract

Project Summary/Abstract
This study will evaluate the implementation of a population health approach to ensuring appropriate
anticoagulant prescribing in a diverse collection of health systems. We will first evaluate the implementation
and effectiveness of the direct oral anticoagulant (DOAC) dashboard that has been used in the Veterans
Health Affairs (VHA) health system since 2016. This will be done by combining the VHA DOAC Dashboard
database with the VHA Corporate Data Warehouse, national death index, and VHA fee-for-service datasets.
The evaluation will follow the reach, effectiveness, adoption, implementation, maintenance (RE-AIM)
evaluation model. Then, we will study the determinants of implementation success within the VHA, a fully
integrated health system, as well as within a collection of non-VHA health systems participating in the Michigan
Anticoagulation Quality Improvement Initiative (MAQI2) to identify differences in the barriers and facilitators of
implementing this tool. To do this, we will conduct semi-structured interviews with key stakeholders at VHA
sites with high, moderate, and low usage of the DOAC Dashboard as well as sites planning to implement the
dashboard within MAQI2. These interviews will be evaluated using template analysis based on the Tailored
Implementation in Chronic Disease (TICD) checklist and the Technology Acceptance Model. Finally, we will
implement and evaluate the DOAC Dashboard within the MAQI2 consortium. We will again use the RE-AIM
evaluation framework and leverage the existing MAQI2 database for analyses. Findings from this study will
lead to improvements in safe management and a reduction in adverse drug events for patients prescribed oral
anticoagulant medications. This study will also identify important differences in the implementation approach
for population health tools between fully integrated and traditional health systems.

## Key facts

- **NIH application ID:** 10133606
- **Project number:** 5R18HS026874-02
- **Recipient organization:** UNIVERSITY OF MICHIGAN AT ANN ARBOR
- **Principal Investigator:** Geoffrey Douglas Barnes
- **Activity code:** R18 (R01, R21, SBIR, etc.)
- **Funding institute:** AHRQ
- **Fiscal year:** 2021
- **Award amount:** $499,545
- **Award type:** 5
- **Project period:** 2020-04-01 → 2023-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10133606

## Citation

> US National Institutes of Health, RePORTER application 10133606, Improving Safe Use of Direct Oral Anticoagulants: A Population Health Approach (5R18HS026874-02). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10133606. Licensed CC0.

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