# Implementing Prescriber-Pharmacist Collaborative Care for Evidence-based Anticoagulant Use

> **NIH AHRQ R18** · UNIVERSITY OF MICHIGAN AT ANN ARBOR · 2021 · $449,999

## Abstract

Project Summary/Abstract
Direct oral anticoagulant medications are commonly used to treat or prevent thrombotic conditions, such as
pulmonary embolism, deep vein thrombosis, and atrial fibrillation. However, up to 10-15% of patients receiving
these medications get unsafe doses based on a patient's kidney or liver function, potential interactions with
other medications, and indication for taking the medication. Alert systems may be beneficial for improving
evidence-based prescribing, but can be burdensome. This study will improve upon existing alert systems by
testing augmentations that encourage collaboration between prescribing health care providers (e.g.,
physicians, nurse practitioners) and expert pharmacists working in anticoagulation clinics and incorporating
dynamic long-term monitoring of patient needs, as well as updates to evidence-based guidelines. Incorporating
state-of-the-art and user-centered design principles, prescribing healthcare providers will be randomized to
different types of electronic health record medication alerts when a patient has an unsafe anticoagulant
prescription. We will identify which alerts are most effective at encouraging evidence-based prescribing, and
will also test moderators to tailor alert delivery to when it most beneficial to ensure evidence-based
anticoagulation prescribing. The specific aims of the project are to (1) implement and evaluate an EHR
medication alert system to improve safe DOAC prescribing through prescriber-pharmacist collaboration; (2)
tailor and refine medication alert delivery to minimize prescriber burden while maximizing effectiveness and
actionability; and (3) assess patient acceptance of and barriers to anticoagulation pharmacist involvement in
medication changes. Findings from this project will establish a framework for implementing prescriber-
pharmacist collaboration for high risk medications, including anticoagulants. If effectively implemented at the
more than 3000 anticoagulation clinics that exist nationally, hundreds of thousands of patients taking direct oral
anticoagulants stand to benefit from safer, evidence-based healthcare.

## Key facts

- **NIH application ID:** 10330852
- **Project number:** 1R18HS028562-01
- **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:** $449,999
- **Award type:** 1
- **Project period:** 2021-09-30 → 2024-09-29

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10330852

## Citation

> US National Institutes of Health, RePORTER application 10330852, Implementing Prescriber-Pharmacist Collaborative Care for Evidence-based Anticoagulant Use (1R18HS028562-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10330852. Licensed CC0.

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