<clinical_study>
  <!-- This xml conforms to an XML Schema at:
    https://clinicaltrials.gov/ct2/html/images/info/public.xsd -->
  <required_header>
    <download_date>ClinicalTrials.gov processed this data on September 20, 2023</download_date>
    <link_text>Link to the current ClinicalTrials.gov record.</link_text>
    <url>https://clinicaltrials.gov/ct2/show/NCT03812848</url>
  </required_header>
  <id_info>
    <org_study_id>165</org_study_id>
    <nct_id>NCT03812848</nct_id>
  </id_info>
  <brief_title>Clinical Pharmacist-led Inpatient Anticoagulation Stewardship Program</brief_title>
  <official_title>Implementation of Clinical Pharmacist-led Inpatient Anticoagulation Stewardship Program in An Egyptian Tertiary Care Hospital</official_title>
  <sponsors>
    <lead_sponsor>
      <agency>Ain Shams University</agency>
      <agency_class>Other</agency_class>
    </lead_sponsor>
  </sponsors>
  <source>Ain Shams University</source>
  <oversight_info>
    <has_dmc>No</has_dmc>
    <is_fda_regulated_drug>No</is_fda_regulated_drug>
    <is_fda_regulated_device>No</is_fda_regulated_device>
  </oversight_info>
  <brief_summary>
    <textblock>
      This study aims at evaluating the implementation of clinical-pharmacist-led anticoagulation&#xD;
      stewardship program in Egyptian tertiary hospital to promote a culture of safety around&#xD;
      anticoagulants.&#xD;
    </textblock>
  </brief_summary>
  <detailed_description>
    <textblock>
      One of the high-alert medication categories that may cause significant patient harm if not&#xD;
      used correctly is anticoagulants. It is not clear if medication errors are more common with&#xD;
      this category in specific compared to other medication categories, but the ramifications of a&#xD;
      medication error with the use of anticoagulation agents is without a doubt detrimental to the&#xD;
      patient's health and more serious than most of other drug categories.&#xD;
&#xD;
      This prospective study evaluates the impact of implementing an anticoagulation stewardship&#xD;
      program, led by clinical pharmacists, on anticoagulation therapy outcomes during patient&#xD;
      hospitalization by the percent of medication errors reduction, percent of adverse drug events&#xD;
      reduction, and percent of evidence-based guidelines compliance improvement.&#xD;
    </textblock>
  </detailed_description>
  <overall_status>Completed</overall_status>
  <start_date type="Actual">January 1, 2018</start_date>
  <completion_date type="Actual">June 5, 2022</completion_date>
  <primary_completion_date type="Actual">June 5, 2022</primary_completion_date>
  <phase>N/A</phase>
  <study_type>Interventional</study_type>
  <has_expanded_access>No</has_expanded_access>
  <study_design_info>
    <allocation>Non-Randomized</allocation>
    <intervention_model>Sequential Assignment</intervention_model>
    <intervention_model_description>Quasi experimental study (separate sample pre-test post-test design)</intervention_model_description>
    <primary_purpose>Health Services Research</primary_purpose>
    <masking>None (Open Label)</masking>
  </study_design_info>
  <primary_outcome>
    <measure>Percent of medication errors change</measure>
    <time_frame>one year and half</time_frame>
    <description>Detect the medication error according to (National Coordinating Council for Medication Errors Reporting and Prevention NCC MERP) Index for Categorizing Medication Errors using NCC MERP Index for Categorizing Medication Errors Algorithm.</description>
  </primary_outcome>
  <primary_outcome>
    <measure>percent of adverse drug events change</measure>
    <time_frame>one year and half</time_frame>
    <description>Detect bleeding and thrombotic-related adverse drug events</description>
  </primary_outcome>
  <primary_outcome>
    <measure>Percent of evidence-based guidelines compliance improvement</measure>
    <time_frame>one year and half</time_frame>
    <description>Detect health care providers' adherence to evidence-based guidelines for anticoagulation therapy.</description>
  </primary_outcome>
  <number_of_arms>2</number_of_arms>
  <enrollment type="Actual">233</enrollment>
  <condition>Deep Vein Thrombosis</condition>
  <condition>Atrial Fibrillation</condition>
  <condition>Mitral Valve Disease</condition>
  <arm_group>
    <arm_group_label>Pre program implementation</arm_group_label>
    <arm_group_type>No Intervention</arm_group_type>
    <description>All hospitalized patients on therapeutic anticoagulant medication during the pre-implementation period of the anticoagulation stewardship program.</description>
  </arm_group>
  <arm_group>
    <arm_group_label>Post program implementation</arm_group_label>
    <arm_group_type>Experimental</arm_group_type>
    <description>All hospitalized patients on therapeutic anticoagulant medication during the post-implementation period of the anticoagulation stewardship program.</description>
  </arm_group>
  <intervention>
    <intervention_type>Other</intervention_type>
    <intervention_name>Anticoagulation Stewardship Program</intervention_name>
    <description>A clinical-pharmacist led anticoagulation stewardship program that includes:&#xD;
Warfarin monitoring and dosing protocol. 1a.Warfarin initial dosing algorithm. 1b.Recommended International normalized ration (INR) target and duration of Warfarin therapy by indication.&#xD;
1c.Warfarin dosage adjustment algorithms.&#xD;
1d.Management of high INR values. 2-Heparin weight-based protocol. 3-Perioperative anticoagulation use protocol. 4-Policies that address baseline and ongoing laboratory monitoring for anticoagulants.&#xD;
5-Protocol for Heparin Induced Thrombocytopenia(HIT) management. 6-Anticoagulation reversal protocol. 7-Booklet for anticoagulant drugs and all of previously prepared protocols. 8-Education programs regarding anticoagulation's therapy for health care team dealing with anticoagulation and patients.</description>
    <arm_group_label>Post program implementation</arm_group_label>
  </intervention>
  <eligibility>
    <criteria>
      <textblock>
        Inclusion Criteria:&#xD;
&#xD;
        All hospitalized patients on therapeutic anticoagulant medication during their&#xD;
        hospitalization period.&#xD;
&#xD;
        Exclusion Criteria:&#xD;
&#xD;
          1. Patients whose age is less than 18 years old.&#xD;
&#xD;
          2. Patients who were admitted for less than 24 hours for patient on parenteral&#xD;
             anticoagulants and less than 48 hours for patient on warfarin.&#xD;
&#xD;
          3. Patients already admitted for bleeding or thrombosis.&#xD;
&#xD;
          4. Malignancy patients.&#xD;
      </textblock>
    </criteria>
    <gender>All</gender>
    <minimum_age>18 Years</minimum_age>
    <maximum_age>N/A</maximum_age>
    <healthy_volunteers>No</healthy_volunteers>
  </eligibility>
  <location>
    <facility>
      <name>Faculty of Pharmacy, Ain Shams University</name>
      <address>
        <city>Cairo</city>
        <zip>11566</zip>
        <country>Egypt</country>
      </address>
    </facility>
  </location>
  <location_countries>
    <country>Egypt</country>
  </location_countries>
  <link>
    <url>http://www.ismp.org/guidelines/standard-order-sets</url>
    <description>Institute for Safe Medication Practices. (2010). ISMP's Guidelines for Standard Order Sets.</description>
  </link>
  <link>
    <url>http://www.ismp.org/recommendations/high-alert-medications-acute-list</url>
    <description>Institute for Safe Medication Practices. (2014). ISMP list of High-Alert Medications</description>
  </link>
  <link>
    <url>http://www.ismp.org/quarterwatch</url>
    <description>Institute for Safe Medication Practices (ISMP) Monitoring FDA MedWatch Reports. (2015, September). Quarter Watch (Q 3-4) 2014. Institute for Safe Medication Practices (ISMP).</description>
  </link>
  <link>
    <url>http://www.ismp.org/quarterwatch?combine=&amp;field_date_posted_value=&amp;page=3</url>
    <description>Institute for Safe Medication Practices (ISMP) ,Quarter Watch (Q4): monitoring FDA MedWatch Reports. (2017, July). Quarter Watch Q4 2016. Retrieved July 13, 2017, from http://www.ismp.org/QuarterWatch/</description>
  </link>
  <link>
    <url>http://www.nccmerp.org/types-medication-errors</url>
    <description>NCCMERP. (2014, July 18). Types of Medication Errors [Text].</description>
  </link>
  <reference>
    <citation>Broussard M, Bass PF 3rd, Arnold CL, McLarty JW, Bocchini JA Jr. Preprinted order sets as a safety intervention in pediatric sedation. J Pediatr. 2009 Jun;154(6):865-8. doi: 10.1016/j.jpeds.2008.12.022. Epub 2009 Feb 1.</citation>
    <PMID>19181332</PMID>
  </reference>
  <reference>
    <citation>Burnett AE, Trujillo TC. The future of inpatient anticoagulation management. J Thromb Thrombolysis. 2013 Apr;35(3):375-86. doi: 10.1007/s11239-013-0892-1.</citation>
    <PMID>23417781</PMID>
  </reference>
  <reference>
    <citation>Dreijer AR, Kruip MJ, Diepstraten J, Polinder S, Brouwer R, Leebeek FW, Vulto AG, van den Bemt PM. Antithrombotic stewardship: a multidisciplinary team approach towards improving antithrombotic therapy outcomes during and after hospitalisation: a study protocol. BMJ Open. 2016 Dec 20;6(12):e011537. doi: 10.1136/bmjopen-2016-011537.</citation>
    <PMID>27998897</PMID>
  </reference>
  <reference>
    <citation>Fanikos J, Stapinski C, Koo S, Kucher N, Tsilimingras K, Goldhaber SZ. Medication errors associated with anticoagulant therapy in the hospital. Am J Cardiol. 2004 Aug 15;94(4):532-5. doi: 10.1016/j.amjcard.2004.04.075.</citation>
    <PMID>15325949</PMID>
  </reference>
  <reference>
    <citation>Garcia DA, Baglin TP, Weitz JI, Samama MM. Parenteral anticoagulants: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012 Feb;141(2 Suppl):e24S-e43S. doi: 10.1378/chest.11-2291. Erratum In: Chest. 2012 May;141(5):1369. Dosage error in article text. Chest. 2013 Aug;144(2):721. Dosage error in article text.</citation>
    <PMID>22315264</PMID>
  </reference>
  <reference>
    <citation>Goldspiel B, Hoffman JM, Griffith NL, Goodin S, DeChristoforo R, Montello CM, Chase JL, Bartel S, Patel JT. ASHP guidelines on preventing medication errors with chemotherapy and biotherapy. Am J Health Syst Pharm. 2015 Apr 15;72(8):e6-e35. doi: 10.2146/sp150001. No abstract available.</citation>
    <PMID>25825193</PMID>
  </reference>
  <reference>
    <citation>Levinson, D. R., &amp; General, I. (2010). Adverse events in hospitals: national incidence among Medicare beneficiaries. Department of Health and Human Services Office of the Inspector General. Retrieved from https://oig.hhs.gov/oei/reports/oei-06-09-00090.pdf</citation>
  </reference>
  <reference>
    <citation>Levy JH, Spyropoulos AC, Samama CM, Douketis J. Direct oral anticoagulants: new drugs and new concepts. JACC Cardiovasc Interv. 2014 Dec;7(12):1333-51. doi: 10.1016/j.jcin.2014.06.014.</citation>
    <PMID>25523529</PMID>
  </reference>
  <reference>
    <citation>Hug BL, Witkowski DJ, Sox CM, Keohane CA, Seger DL, Yoon C, Matheny ME, Bates DW. Adverse drug event rates in six community hospitals and the potential impact of computerized physician order entry for prevention. J Gen Intern Med. 2010 Jan;25(1):31-8. doi: 10.1007/s11606-009-1141-3. Epub 2009 Nov 6.</citation>
    <PMID>19894081</PMID>
  </reference>
  <reference>
    <citation>Lysogorski MC, Hassan AK, Lampkin SJ, Geisler R. The impact of pharmacy monitoring and intervention in patients receiving intravenous heparin. Int J Clin Pharm. 2017 Aug;39(4):844-850. doi: 10.1007/s11096-017-0482-y. Epub 2017 May 15.</citation>
    <PMID>28508323</PMID>
  </reference>
  <reference>
    <citation>Padron M, Miyares MA. Development of an anticoagulation stewardship program at a large tertiary care academic institution. J Pharm Pract. 2015 Feb;28(1):93-8. doi: 10.1177/0897190013514091. Epub 2013 Dec 10.</citation>
    <PMID>24326411</PMID>
  </reference>
  <reference>
    <citation>Reardon DP, Atay JK, Ashley SW, Churchill WW, Berliner N, Connors JM. Implementation of a Hemostatic and Antithrombotic Stewardship program. J Thromb Thrombolysis. 2015 Oct;40(3):379-82. doi: 10.1007/s11239-015-1189-3.</citation>
    <PMID>25669625</PMID>
  </reference>
  <reference>
    <citation>Rose, A. (Ed.). (2015). Anticoagulation Management. Cham: Springer International Publishing. https://doi.org/10.1007/978-3-319-22602-6</citation>
  </reference>
  <reference>
    <citation>Sharma M, Krishnamurthy M, Snyder R, Mauro J. Reducing Error in Anticoagulant Dosing via Multidisciplinary Team Rounding at Point of Care. Clin Pract. 2017 Apr 20;7(2):953. doi: 10.4081/cp.2017.953. eCollection 2017 Apr 6.</citation>
    <PMID>28484587</PMID>
  </reference>
  <reference>
    <citation>U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. (2014). Anticoagulants. In National Action Plan for Adverse Drug Event Prevention.</citation>
  </reference>
  <reference>
    <citation>World Health organization, W. H., &amp; others. (2016). Medication Errors: Technical Series on Safer Primary Care ISBN 978-92-4-151164-3. Retrieved from http://apps.who.int/iris/bitstream/10665/252275/1/9789241511650-eng.pdf</citation>
  </reference>
  <reference>
    <citation>Wychowski MK, Ruscio CI, Kouides PA, Sham RL. The scope and value of an anticoagulation stewardship program at a community teaching hospital. J Thromb Thrombolysis. 2017 Apr;43(3):380-386. doi: 10.1007/s11239-016-1455-z.</citation>
    <PMID>27878507</PMID>
  </reference>
  <verification_date>September 2022</verification_date>
  <study_first_submitted>January 18, 2019</study_first_submitted>
  <study_first_submitted_qc>January 18, 2019</study_first_submitted_qc>
  <study_first_posted type="Actual">January 23, 2019</study_first_posted>
  <last_update_submitted>September 19, 2022</last_update_submitted>
  <last_update_submitted_qc>September 19, 2022</last_update_submitted_qc>
  <last_update_posted type="Actual">September 21, 2022</last_update_posted>
  <responsible_party>
    <responsible_party_type>Principal Investigator</responsible_party_type>
    <investigator_affiliation>Ain Shams University</investigator_affiliation>
    <investigator_full_name>Heba Mohamed El-Bosily</investigator_full_name>
    <investigator_title>Clinical Pharmacist</investigator_title>
  </responsible_party>
  <keyword>anticoagulation</keyword>
  <keyword>stewardship program</keyword>
  <keyword>anticoagulants</keyword>
  <keyword>clinical pharmacist</keyword>
  <keyword>heparin</keyword>
  <keyword>warfarin</keyword>
  <condition_browse>
    <!-- CAUTION:  The following MeSH terms are assigned with an imperfect algorithm            -->
    <mesh_term>Atrial Fibrillation</mesh_term>
    <mesh_term>Thrombosis</mesh_term>
    <mesh_term>Venous Thrombosis</mesh_term>
  </condition_browse>
  <patient_data>
    <sharing_ipd>Undecided</sharing_ipd>
    <ipd_description>It is not clear according to the clinical research guidelines at Faculty of Pharmacy, Ain Shams University.</ipd_description>
  </patient_data>
  <!-- Results have not yet been posted for this study                                          -->
</clinical_study>


download date: ClinicalTrials.gov processed this data on September 20, 2023
link text: Link to the current ClinicalTrials.gov record.
url: https://clinicaltrials.gov/ct2/show/NCT03812848
org study id: 165
nct id: NCT03812848
lead sponsor: 
has dmc: No
is fda regulated drug: No
is fda regulated device: No
This study aims at evaluating the implementation of clinical-pharmacist-led anticoagulation
      stewardship program in Egyptian tertiary hospital to promote a culture of safety around
      anticoagulants.
One of the high-alert medication categories that may cause significant patient harm if not
      used correctly is anticoagulants. It is not clear if medication errors are more common with
      this category in specific compared to other medication categories, but the ramifications of a
      medication error with the use of anticoagulation agents is without a doubt detrimental to the
      patient's health and more serious than most of other drug categories.

      This prospective study evaluates the impact of implementing an anticoagulation stewardship
      program, led by clinical pharmacists, on anticoagulation therapy outcomes during patient
      hospitalization by the percent of medication errors reduction, percent of adverse drug events
      reduction, and percent of evidence-based guidelines compliance improvement.
allocation: Non-Randomized
intervention model: Sequential Assignment
intervention model description: Quasi experimental study (separate sample pre-test post-test design)
primary purpose: Health Services Research
masking: None (Open Label)
measure: Percent of medication errors change
time frame: one year and half
description: Detect the medication error according to (National Coordinating Council for Medication Errors Reporting and Prevention NCC MERP) Index for Categorizing Medication Errors using NCC MERP Index for Categorizing Medication Errors Algorithm.
measure: percent of adverse drug events change
time frame: one year and half
description: Detect bleeding and thrombotic-related adverse drug events
measure: Percent of evidence-based guidelines compliance improvement
time frame: one year and half
description: Detect health care providers' adherence to evidence-based guidelines for anticoagulation therapy.
arm group label: Pre program implementation
arm group type: No Intervention
description: All hospitalized patients on therapeutic anticoagulant medication during the pre-implementation period of the anticoagulation stewardship program.
arm group label: Post program implementation
arm group type: Experimental
description: All hospitalized patients on therapeutic anticoagulant medication during the post-implementation period of the anticoagulation stewardship program.
intervention type: Other
intervention name: Anticoagulation Stewardship Program
description: A clinical-pharmacist led anticoagulation stewardship program that includes:
Warfarin monitoring and dosing protocol. 1a.Warfarin initial dosing algorithm. 1b.Recommended International normalized ration (INR) target and duration of Warfarin therapy by indication.
1c.Warfarin dosage adjustment algorithms.
1d.Management of high INR values. 2-Heparin weight-based protocol. 3-Perioperative anticoagulation use protocol. 4-Policies that address baseline and ongoing laboratory monitoring for anticoagulants.
5-Protocol for Heparin Induced Thrombocytopenia(HIT) management. 6-Anticoagulation reversal protocol. 7-Booklet for anticoagulant drugs and all of previously prepared protocols. 8-Education programs regarding anticoagulation's therapy for health care team dealing with anticoagulation and patients.
arm group label: Post program implementation
criteria: 
gender: All
minimum age: 18 Years
maximum age: N/A
healthy volunteers: No
facility: 
country: Egypt
url: http://www.ismp.org/guidelines/standard-order-sets
description: Institute for Safe Medication Practices. (2010). ISMP's Guidelines for Standard Order Sets.
url: http://www.ismp.org/recommendations/high-alert-medications-acute-list
description: Institute for Safe Medication Practices. (2014). ISMP list of High-Alert Medications
url: http://www.ismp.org/quarterwatch
description: Institute for Safe Medication Practices (ISMP) Monitoring FDA MedWatch Reports. (2015, September). Quarter Watch (Q 3-4) 2014. Institute for Safe Medication Practices (ISMP).
url: http://www.ismp.org/quarterwatch?combine=&field_date_posted_value=&page=3
description: Institute for Safe Medication Practices (ISMP) ,Quarter Watch (Q4): monitoring FDA MedWatch Reports. (2017, July). Quarter Watch Q4 2016. Retrieved July 13, 2017, from http://www.ismp.org/QuarterWatch/
url: http://www.nccmerp.org/types-medication-errors
description: NCCMERP. (2014, July 18). Types of Medication Errors [Text].
citation: Broussard M, Bass PF 3rd, Arnold CL, McLarty JW, Bocchini JA Jr. Preprinted order sets as a safety intervention in pediatric sedation. J Pediatr. 2009 Jun;154(6):865-8. doi: 10.1016/j.jpeds.2008.12.022. Epub 2009 Feb 1.
PMID: 19181332
citation: Burnett AE, Trujillo TC. The future of inpatient anticoagulation management. J Thromb Thrombolysis. 2013 Apr;35(3):375-86. doi: 10.1007/s11239-013-0892-1.
PMID: 23417781
citation: Dreijer AR, Kruip MJ, Diepstraten J, Polinder S, Brouwer R, Leebeek FW, Vulto AG, van den Bemt PM. Antithrombotic stewardship: a multidisciplinary team approach towards improving antithrombotic therapy outcomes during and after hospitalisation: a study protocol. BMJ Open. 2016 Dec 20;6(12):e011537. doi: 10.1136/bmjopen-2016-011537.
PMID: 27998897
citation: Fanikos J, Stapinski C, Koo S, Kucher N, Tsilimingras K, Goldhaber SZ. Medication errors associated with anticoagulant therapy in the hospital. Am J Cardiol. 2004 Aug 15;94(4):532-5. doi: 10.1016/j.amjcard.2004.04.075.
PMID: 15325949
citation: Garcia DA, Baglin TP, Weitz JI, Samama MM. Parenteral anticoagulants: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012 Feb;141(2 Suppl):e24S-e43S. doi: 10.1378/chest.11-2291. Erratum In: Chest. 2012 May;141(5):1369. Dosage error in article text. Chest. 2013 Aug;144(2):721. Dosage error in article text.
PMID: 22315264
citation: Goldspiel B, Hoffman JM, Griffith NL, Goodin S, DeChristoforo R, Montello CM, Chase JL, Bartel S, Patel JT. ASHP guidelines on preventing medication errors with chemotherapy and biotherapy. Am J Health Syst Pharm. 2015 Apr 15;72(8):e6-e35. doi: 10.2146/sp150001. No abstract available.
PMID: 25825193
citation: Levinson, D. R., & General, I. (2010). Adverse events in hospitals: national incidence among Medicare beneficiaries. Department of Health and Human Services Office of the Inspector General. Retrieved from https://oig.hhs.gov/oei/reports/oei-06-09-00090.pdf
citation: Levy JH, Spyropoulos AC, Samama CM, Douketis J. Direct oral anticoagulants: new drugs and new concepts. JACC Cardiovasc Interv. 2014 Dec;7(12):1333-51. doi: 10.1016/j.jcin.2014.06.014.
PMID: 25523529
citation: Hug BL, Witkowski DJ, Sox CM, Keohane CA, Seger DL, Yoon C, Matheny ME, Bates DW. Adverse drug event rates in six community hospitals and the potential impact of computerized physician order entry for prevention. J Gen Intern Med. 2010 Jan;25(1):31-8. doi: 10.1007/s11606-009-1141-3. Epub 2009 Nov 6.
PMID: 19894081
citation: Lysogorski MC, Hassan AK, Lampkin SJ, Geisler R. The impact of pharmacy monitoring and intervention in patients receiving intravenous heparin. Int J Clin Pharm. 2017 Aug;39(4):844-850. doi: 10.1007/s11096-017-0482-y. Epub 2017 May 15.
PMID: 28508323
citation: Padron M, Miyares MA. Development of an anticoagulation stewardship program at a large tertiary care academic institution. J Pharm Pract. 2015 Feb;28(1):93-8. doi: 10.1177/0897190013514091. Epub 2013 Dec 10.
PMID: 24326411
citation: Reardon DP, Atay JK, Ashley SW, Churchill WW, Berliner N, Connors JM. Implementation of a Hemostatic and Antithrombotic Stewardship program. J Thromb Thrombolysis. 2015 Oct;40(3):379-82. doi: 10.1007/s11239-015-1189-3.
PMID: 25669625
citation: Rose, A. (Ed.). (2015). Anticoagulation Management. Cham: Springer International Publishing. https://doi.org/10.1007/978-3-319-22602-6
citation: Sharma M, Krishnamurthy M, Snyder R, Mauro J. Reducing Error in Anticoagulant Dosing via Multidisciplinary Team Rounding at Point of Care. Clin Pract. 2017 Apr 20;7(2):953. doi: 10.4081/cp.2017.953. eCollection 2017 Apr 6.
PMID: 28484587
citation: U.S. Department of Health and Human Services, Office of Disease Prevention and Health Promotion. (2014). Anticoagulants. In National Action Plan for Adverse Drug Event Prevention.
citation: World Health organization, W. H., & others. (2016). Medication Errors: Technical Series on Safer Primary Care ISBN 978-92-4-151164-3. Retrieved from http://apps.who.int/iris/bitstream/10665/252275/1/9789241511650-eng.pdf
citation: Wychowski MK, Ruscio CI, Kouides PA, Sham RL. The scope and value of an anticoagulation stewardship program at a community teaching hospital. J Thromb Thrombolysis. 2017 Apr;43(3):380-386. doi: 10.1007/s11239-016-1455-z.
PMID: 27878507
responsible party type: Principal Investigator
investigator affiliation: Ain Shams University
investigator full name: Heba Mohamed El-Bosily
investigator title: Clinical Pharmacist
mesh term: Atrial Fibrillation
mesh term: Thrombosis
mesh term: Venous Thrombosis
sharing ipd: Undecided
ipd description: It is not clear according to the clinical research guidelines at Faculty of Pharmacy, Ain Shams University.