when the anticoagulant medication was initiated. (Evidence Quality: V; Recommendation Strength: Theoretical/foundational) Action Statement Profile Aggregate Evidence Quality: Level V Benefit: Decreased risk of a PE in patients who are adequately anti-coagulated Risk, Harm, Cost: Risk of bleeding with anticoagulation, risk of adverse effects with restrictions in inactivity, and cost of new anticoagulants may be prohibitive in those with inadequate pharmacy insurance coverage. Benefit-Harm Assessment: Preponderance of benefit over harm Value Judgments: Intentional Vagueness: This clinical practice guideline has provided therapeutic ranges for anticoagulants that have been provided by the manufacturers due to the limited evidence beyond this. While the recommendation strength is weak based upon scientific evidence, the GDG considers it prudent to follow the manufacturer’s recommendations. Role of Patient Preference: Patients should be informed of the importance for continuing anticoagulation upon discharge from the hospital as different anticoagulants require monitoring, cost, and modification of diet and bleeding risk. Exclusions: None Summary of Evidence Anticoagulants are the primary defense used to prevent and treat a LE DVT and consequent PE and/or PTS. Contrary to popular belief, anticoagulants do not actively dissolve a blood clot, but instead prevent new clots from forming. Although anticoagulants are often referred to as blood thinners, they do not actually thin the blood. This class of drugs works by altering certain chemicals in the blood necessary for clotting to occur. Consequently, blood clots are less likely to form in the veins or arteries, and yet continue to form where needed. While anticoagulants do not break down clots that have already formed, they do allow the body's natural clot lysis mechanisms to work normally to break down clots that have formed.
when the anticoagulant medication was initiated. (Evidence Quality: V; Recommendation Strength: Theoretical/foundational) Action Statement Profile Aggregate Evidence Quality: Level V Benefit: Decreased risk of a PE in patients who are adequately anti-coagulated Risk, Harm, Cost: Risk of bleeding with anticoagulation, risk of adverse effects with restrictions in inactivity, and cost of new anticoagulants may be prohibitive in those with inadequate pharmacy insurance coverage. Benefit-Harm Assessment: Preponderance of benefit over harm Value Judgments: Intentional Vagueness: This clinical practice guideline has provided therapeutic ranges for anticoagulants that have been provided by the manufacturers due to the limited evidence beyond this. While the recommendation strength is weak based upon scientific evidence, the GDG considers it prudent to follow the manufacturer’s recommendations. Role of Patient Preference: Patients should be informed of the importance for continuing anticoagulation upon discharge from the hospital as different anticoagulants require monitoring, cost, and modification of diet and bleeding risk. Exclusions: None Summary of Evidence Anticoagulants are the primary defense used to prevent and treat a LE DVT and consequent PE and/or PTS. Contrary to popular belief, anticoagulants do not actively dissolve a blood clot, but instead prevent new clots from forming. Although anticoagulants are often referred to as blood thinners, they do not actually thin the blood. This class of drugs works by altering certain chemicals in the blood necessary for clotting to occur. Consequently, blood clots are less likely to form in the veins or arteries, and yet continue to form where needed. While anticoagulants do not break down clots that have already formed, they do allow the body's natural clot lysis mechanisms to work normally to break down clots that have formed.