Anticoagulation Therapy Management for Pharmacists

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Jessica J. Edwards Lucas, Pharm. D., BCACP
Clinical Pharmacy Specialist
Malcom Randall VA Merical Center

Joseph J. Fierro, Pharm. D., BCACP
Clinical Pharmacy Specialist in Ambulatory Care/Specialty Clinics
Program Director, Pharmacy Residency Program
James A. Haley Veterans Hospital

Abby Rivas Marrero, Pharm.D., BCPS, BCCP
Clinical Pharmacy Manager
West Kendall Baptist Hospital

Intended Audience

ACPE  Universal Activity Number

Contact Hours


Dates Available
10/10/2016 to 10/10/2019

Activity Type



This course is intended for pharmacists who manage or who plan to manage patients who have diseases and disorders requiring anticoagulation therapy. The major course objective is for pharmacists to achieve a high level of confidence with patients who require anticoagulation and with their primary care physician.  This confidence is the result of a greater depth of understanding the patient’s disease state, the therapy used and the monitoring parameters for patients receiving anticoagulation agents.


  • Relate how pharmacokinetics and pharmacodymanics principles are used to achieve and maintain anticoagulation control within the patient’s therapy goals.
  • Describe the complexities of managing drug therapy and other treatment modalities.
  • Summarize how pharmaceutical care is applied for patients requiring anticoagulation therapy.
  • Use effective interpersonal skills to better educate patients, caregivers, and other healthcare professionals regarding safe and optimal anticoagulation therapy.
  • Design an anticoagulation management service for effective patient care.
  • Document anticoagulation therapy for patients receiving such therapy.


The University of Florida’s Anticoagulant Therapy Certificate Program provides the extensive training and information you need to manage the pharmacotherapy of patients on anticoagulant therapy.

You will be prepared to:

  • Assess and monitor patient’s condition.
  • Manage complex drug therapy.
  • Efficiently coordinate documentation and record keeping.
  • Apply specialized counseling and teaching skills to better manage and care for patients.
  • Market and promote the growth of specialized skills.
  • Generate new income within the pharmacy.
  • Deal with issues related to referral, billing, and budgeting for new services.

This 12-week program contains six independent learning modules of self-paced study using multimedia presentations and Internet-based assignments. The course contains skill-builders, which are  practice-based assignments that assist participants to utilize knowledge gained from the video presentations and required readings to develop monitoring and management skills.

Module 1:
Updates in Outpatient Anticoagulation Management: An Overview
  • Describe how clotting occurs and the morbidity associated with clots
  • Review the clotting cascade and how pharmacotherapy targets this process
  • Explain pertinent pharmacokinetic, drug/drug and drug/food interactions that can occur with patients on vitamin-K antagonists
  • Review basic pathophysiology and appropriate treatment options for patients requiring anticoagulation treatment for the following conditions
    1. Atrial fibrillation
    2. Valve disorders
  • State how a pharmacist can identify, assess and solve medication-related problems for patients on anticoagulation therapy
Module 2:
Inpatient Anticoagulation Therapy
  • Identify and assess risk factors, indications, and other applicable considerations to initiate, transition, or modify anticoagulant therapy for inpatients
  • Review and evaluate the options for anticoagulation therapy for different inpatient populations, goals of therapy, and co-morbidities
  • Apply clinical, safety, and financial considerations to:
  1. Select the most appropriate agent,
  2. Develop the patients’ anticoagulation therapy plan
  3. Monitor and evaluate safety and efficacy parameters for therapy, and
  4. Make recommendations to modify and/or optimize the anticoagulation therapy to achieve the desired outcomes
  • Evaluate and modify anticoagulant therapy in preparation for the transition of the patient’s care to home or a different level of care, based on patient-specific risk factors, adherence to therapy, and requirement for follow up
  • Provide patient education with the goal to optimize therapy and prevent the risk of adverse medication events associated with anticoagulant therapy
Module 3:
Anticoagulation Management of DVT and PE
  • List the risk factors for developing a DVT and/or PE
  • Identify the signs and symptoms of a DVT and PE
  • Discuss duration of treatment based on the type of DVT and PE and other risk factors
  • Discuss non-pharmacological therapies, and when not to recommend anticoagulation therapy.
  • Discuss the pharmacological treatments for DVT and PE
  • Complete a case study involving a DVT or PE
Module 4:
  • Describe the clinical conundrum when anticoagulation therapy needs to be interrupted
  • Review CHEST Guideline recommendations regarding periprocedural management and compare and contrast more recent periprocedural literature
  • Explain the decision-making process when developing a patient-specific plan for patients on anticoagulants undergoing procedure
  • Elective versus urgent procedures
  • Low-risk versus high-risk bleeding procedures
Module 5:
Complication with Anticoagulation
  • Recognize complications of antithrombotic therapy
  • Review the recommendations and options to manage complications associated with anticoagulants, including the reversal of antithrombotic effect
  • Develop a treatment plan to manage complications associated with antithrombotic therapy
Module 6:
Medication Therapy Management
  • Evaluate the need of medication therapy management services within the scope of an anticoagulation clinic.
  • Understand the core components of medication therapy management.
  • Explain the rationale and benefits of utilizing medication therapy management in an inpatient, outpatient or consultant role in anticoagulation monitoring.
  • Understand and discuss the cost, staffing and management of performing MTM services to patient’s in anticoagulation clinics.
  • Explore the billing mechanisms that could be used to be reimbursed for MTM services in anticoagulation clinic settings.
  • Review methods such as motivational interviewing that can be used to gain knowledge about patient’s understanding of the importance of anticoagulation therapy.
  • Define the parameters that could be used to access the efficiency and return on investment, including quality parameters to access medication therapy management and it’s importance to anticoagulation clinic patients.
  • Incorporate patient interviewing and teaching skills into medication therapy management sessions to support, educate and encourage behaviors meeting current recommended guidelines for patient’s on anticoagulation therapy

Schedule of Activities/Requirements for Sucessful Course Completion

  • Complete all six modules (ie. view all six recorded lectures and read the supplemental materials)
  • Submit the required module assignments
  • Receive 80% or higher on all six module quizzes
  • Complete an online program evaluation

Program Financial Support

This course received no outside funding support.

Acknowledgements and Disclosures

Jessica J. Edwards Lucas, Pharm. D., BCACP has disclosed that she has no relevant financial disclosures. No one else in a position to control content has any financial relationships to disclose.

Joseph J. Fierro, Pharm. D., BCACP has disclosed that she has no relevant financial disclosures. No one else in a position to control content has any financial relationships to disclose.

Abby Rivas Marrero, Pharm.D., BCPS, BCCP has disclosed that she has no relevant financial disclosures. No one else in a position to control content has any financial relationships to disclose.


All pharmacists who successfully pass the course will receive instructions on how to download a course certificate.

Computer Requirements

Computer and Internet access are required to complete this course. Course content is provided via Canvas.

The minimum hardware, software, and Internet requirements for Canvas can be found here.


Refund Policy for CE Courses

Privacy and Confidentiality Policy

Reporting Credit

The University of Florida College of Pharmacy will report credit to CPE Monitor and CE Broker when applicable. If you would like a paper statement of credit, you may print it from your NABP e-profile.


This course  in its entirety is copyrighted by the University of Florida Continuing Pharmacy Education and may not be duplicated or reproduced for any other purpose without specific written permission.

Contact Information

For questions or more information, please contact our office.

ACPE LogoThe University of Florida College of Pharmacy is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.