Anticoagulation in clinically difficult situations: insights into safe and effective management

Self-managed anticoagulation is safe and effective.

We read with interest the article by Christensen et al. [1] and agree with their conclusion that self-managed anticoagulation is an effective method of managing oral anticoagulation therapy. In their review of the literature, we were surprised that they did not include a prospective randomised trial from our unit [2]. Our own program was initiated after a presentation by Dr. Hasenkam at the EAC...

Safe and Effective Anticoagulation in the Outpatient Setting

Home infusion: Safe, clinically effective, patient preferred, and cost saving.

BACKGROUND As the U.S. healthcare payment system shifts from volume to value, identifying care approaches that improve outcomes while lowering costs are essential. We sought to understand the utility of home infusion versus medical-setting infusion as a mechanism to affect the three-part aim: better care, better health outcomes, and lower costs. STUDY DESIGN Systematic review. METHODS We se...

Safe per-operative anticoagulation.

Interrogating Assumptions about “ Difficult ” Patients and Situations

The phenomenon of health care professionals labeling patients as “difficult” is not limited to psychiatric settings and literature. In the broader medical literature, patients have been described in similar terms as “hateful” [3] or “heartsink” [4]. The description of this phenomenon in different health care settings during decades of practice and as explored in the health professions literatur...