Anticoagulants are high-risk medications that can cause severe bleeding when not administered or monitored correctly. Conversely, patients prescribed anticoagulants who are underdosed can suffer thromboembolic complications. Complex dosing requirements, insufficient monitoring, and inconsistent patient compliance can contribute to adverse drug events or even death.

The UConn Health Anticoagulation Clinic was established to improve safety and efficacy outcomes by preventing new or recurrent thromboembolic events and avoiding adverse drug events for patients prescribed anticoagulants in a cost-effective manner while allowing providers more availability of clinic time for direct patient care.

The clinic staff provides ongoing management, including dosing, monitoring, education, prescription needs, and support for all UConn Health patients prescribed warfarin.

The clinic is staffed by pharmacists with specialized training in anticoagulation management who work under a collaborative practice agreement with the referring UConn Health attending physicians.

Dr. Heiko Schmitt (cardiologist) and Dr. Ritika Vankina (hematologist) provide clinical oversight to ensure evidence-based practice guidelines are being followed by clinic staff.

Through a comprehensive process that includes on-site laboratory testing, the clinic monitors the patient's therapy and adjusts dosages according to protocol. At each visit, the clinic staff monitors patients for hemorrhagic and thromboembolic complications and provides patient education regarding the safe use of anticoagulation therapy.

Benefits to Patients

• Comprehensive, ongoing patient education and communication
• Consistent and prompt INR monitoring
• Prompt dosage adjustments
• Intervention for drug interactions

Patients may be followed up on an electronically submitted referral from an attending physician.

Anticoagulation Referral Acceptance Requirements

1. Patients may be referred to the Anticoagulation Clinic if they have a UConn attending physician willing to be in a collaborative practice agreement for that patient.
2. Patients must be willing to come to the Anticoagulation Clinic at least quarterly or 4 times a year and meet with their referring physician at least once a year.
3. Patients will be scheduled in the clinic after an initial outpatient visit with the referring physician; this is a regulatory and billing compliance requirement.
4. Please enter an order for “Ambulatory Referral to Anticoagulation Monitoring” in Epic, sending INR reminders to UMSI Anticoagulation Support Staff.
5. Upon receipt of the Anticoagulation referral, the Anticoagulation Clinic support staff will submit an electronic collaborative practice agreement to the referring physician for co-signature.
6. The anticoagulation clinic staff will contact the patient within 2 business days after both the referral and co-signed collaborative practice agreement has been received.
7. Please call the Anticoagulation Clinic at 860-679-3470 to ensure the proper documentation is in place.
8. The anticoagulation clinic staff will reach out to physicians yearly to renew both the referral and collaborative practice agreement as required under the collaborative practice agreement.