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01-08-2019 | Anticoagulant | Original Article

Application-based management of perioperative anticoagulant therapy: description of POPACTApp

Authors: Michael Thomaschewski, Florens Beyer, Martin Thomaschewski, David Ellebrecht, Markus Jonczyk, Matthias Schneider, Tobias Keck, Tilo Mentler, Richard Hummel

Published in: Langenbeck's Archives of Surgery | Issue 5/2019

Abstract

Purpose

Perioperative management of oral anticoagulation (OAC) is a constant challenge in interventional and surgical procedures. When deciding to discontinue OAC, the risk of thromboembolic events must be balanced against the risk of bleeding during and after the planned procedure. These risks differ across patients and must be considered individually.

Methods

POPACTApp, an application for the perioperative or peri-interventional management of oral anticoagulants, was developed using a human-centered design process (ISO 9241-210:2010). The treatment concept developed here can be adapted to a patient’s individual risk profile. POPACTApp provides recommendations based on guidelines, consensus statements, and study data. After entering patient-specific risk factors, the attending physician using POPACTApp receives a clear and direct presentation of a periprocedural treatment concept, which should enable the efficient use of the program in everyday clinical practice. The perioperative treatment concept is presented via a timeline, including (1) the decision on whether to interrupt OAC, (2) the timing of the last preoperative administration of OAC in cases of interruption, (3) the decision on whether and how to bridge with heparins, and (4) the decision about when to reinitiate anticoagulation.

Results

A task-based survey to evaluate POPACTApp’s usability conducted with 20 surgeons showed that all clinicians correctly interpreted the recommendations provided by the app. Further, a questionnaire using a 7-point Likert scale from − 3 (negative) to + 3 (positive) revealed the following results to three specific questions: (1) satisfaction with the current standard procedure in the respective unit of the participant (0.15; SD = 1.57), (2) individual satisfaction with the POPACTApp application (2.7; SD = 0.47), and (3) estimation of the usefulness of POPACTApp for clinical practice (2.7; SD = 0.47).

Conclusions

POPACTApp provides clinicians with an individual risk-optimized treatment concept for the perioperative or peri-interventional management of OAC based on current guidelines, consensus statements, and study data, enabling the standardized perioperative handling of OAC in daily clinical practice.

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Title: Application-based management of perioperative anticoagulant therapy: description of POPACTApp
Authors: Michael Thomaschewski
Florens Beyer
Martin Thomaschewski
David Ellebrecht
Markus Jonczyk
Matthias Schneider
Tobias Keck
Tilo Mentler
Richard Hummel
Publication date: 01-08-2019
Publisher: Springer Berlin Heidelberg
Keywords: Anticoagulant
Atrial Fibrillation
Heparin
Low Molecular Weight Heparin
Published in: Langenbeck's Archives of Surgery / Issue 5/2019
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-019-01796-9

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Application-based management of perioperative anticoagulant therapy: description of POPACTApp

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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