1. Anticoagulation medications help prevent life-threatening events such as pulmonary embolism, but they also increase the risks of major bleeding.
2. Patient safety practices such as patient and caregiver education and periodic international normalized ratio testing to increase medication adherence may potentially prevent adverse effects of anticoagulant use during care transitions and in the ambulatory setting.
3. For care transitions, specifically for discharge from the hospital to home, we included three randomized trials and three non-randomized studies, and all six were at high risk of bias. Only one of the six studies (a nonrandomized study) found evidence of a benefit on any adverse event. No included studies addressed other types of care transitions (e.g., within-hospital).
4. Most telemedicine interventions to prevent adverse events of anticoagulation in the ambulatory setting improved time in therapeutic range, and telepharmacy reduced rates of bleeding and hospitalization. Anti-Xa monitoring lowered rates of thromboembolic events while maintaining similar rates of major bleeding compared to usual care. The evidence was inconclusive about the effect of education and remote monitoring on adverse events in people on anticoagulation.
5. We identified two relevant toolkits from AHRQ’s Patient Safety Network (both from 2012). One provided general medication guidance for the transition to home, and the other provided six tools either for the delivery or provision of a medication treatment management program or for assessing the effect of such a program.

Treadwell JR, Jepson C, Ivlev I, Reston JT. Reducing Adverse Drug Events Related to Anticoagulant Use in Adults. Rapid Response. (Prepared by the ECRI-Penn Evidence-based Practice Center under Contract No. 75Q80120D00003). AHRQ Publication No. 23(24)-EHC019-7. Rockville, MD: Agency for Healthcare Research and Quality. January 2024. Posted final reports are located on the Effective Health Care Program search page.