Available Until 2/24/2024

Anticoagulation Certificate

ACPE Numbers: Various - see below 
Release Date:
 February 24, 2021
Expiration Date: February 24, 2024
Activity Type: Application-based
CE Contact Hour(s): 32 hours
Activity Fee: $445.00/$545.00 member/non-member

Overview 

This self-guided, online program will provide 32 hours of ACPE continuing education for pharmacists, incorporating recorded presentations, skill-focused activities, and supportive readings. 

The modules are designed to provide focused education on anticoagulation therapy management, beginning with regulatory drivers and the concept of anticoagulation stewardship; continuing through the medications that comprise anticoagulation therapy and their use in various acute care, ambulatory, and perioperative settings; the unique needs of specialty populations; adverse effect monitoring and management; interpretation of laboratory assays and application to care, and more. Throughout the program, skills needed to be an effective anticoagulation practitioner are discussed. Case studies will be discussed in depth, with practical, real-world situations explored and approaches to treatment explained. Upon completion of all the modules, learners should be proficient in anticoagulation therapy management.

Professional Certificate Requirement 

Once a learner has successfully completed the educational curriculum, he/she will have the opportunity to complete a 75 question comprehensive exam. If the learner successfully completes the exam (minimum 80% passing rate; unlimited attempts permitted), he/she will be eligible to earn the professional certificate.

The American Society of Health-System Pharmacists is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

This activity is intended for pharmacists seeking to expand their knowledge and skills in anticoagulation therapy management.

Introduction to Anticoagulation
0204-0000-21-714-H04-P

  • Describe milestones in the evolving use and management of anticoagulation therapy.
  • Name regulatory oversights for managing anticoagulation therapy.
  • Explain the importance of pharmacists adapting anticoagulation therapy to optimize the overall management plan.
  • Describe the core elements of an antithrombotic stewardship program.
  • Apply principles of antithrombotic stewardship within your current practice site.

Heparin, Low Molecular Weight Heparin, and Venous Thromboembolism Prophylaxis
0204-0000-21-715-H01-P

  • Identify the differences among unfractionated heparin, low molecular weight heparin (LMWH), and fondaparinux.
  • Describe how to initiate and monitor heparin, low molecular weight heparin, and fondaparinux for various indications.
  • Discuss how to adjust heparin, low molecular weight heparin, and fondaparinux based on patient specific considerations
  • Apply a venous thromboembolism risk assessment model to determine risk for venous thrombosis in medical or surgical patients.
  • Compare the difference in safety and efficacy of venous thromboembolism prophylaxis regimens in medical or surgical patients.
  • Design an optimal venous thromboembolism prophylaxis regimen in medical or surgical patients.

Arterial Disease and Venous Thromboembolism Treatment
0204-0000-21-716-H01-P

  • Describe how acute venous thromboembolism (VTE) is diagnosed.
  • List evidence-based anticoagulant options with recommended dosing for initial VTE treatment.
  • Design an individualized anticoagulant plan for a patient with an acute VTE case including riskbenefit assessment and determination of duration of anticoagulant therapy.
  • Compare and contrast the key characteristics and treatment considerations for arterial versus venous thromboembolism.
  • Design an appropriate antithrombotic treatment regimen for coronary artery disease patients who also have either atrial fibrillation or venous thromboembolism.
  • Design an appropriate antithrombotic treatment regimen for peripheral artery disease and cardiovascular disease patients.

Thrombolytic Therapy
0204-0000-21-717-H01-P

  • Given a patient case, assess a patient’s potential benefits and risks, including contraindications, associated with thrombolytic therapy.
  • Design an appropriate thrombolytic treatment plan for a patient with a life- or limb threatening thrombosis.
  • Design a subsequent antithrombotic treatment plan for a patient with a life- or limb threatening thrombosis.

Warfarin and Focus on the Ambulatory Setting
0204-0000-21-718-H01-P

  • Select an appropriate starting dose, INR follow-up plan, and key patient education points for a patient starting warfarin therapy.
  • Determine an appropriate dosing/management strategy based on the clinical situation when a patient on warfarin presents to the hospital.
  • Determine an appropriate dosing/management strategy based on the clinical situation when a hospitalized patient on warfarin transitions to a different level of care (critical care, sub-acute, home).
  • Develop an effective management strategy when a patient experiences a clinically significant drug-drug or dietary interaction.
  • Formulate an effective management strategy when presented with an ambulatory patient struggling with warfarin therapy.
  • Identify the key components, characteristics, and activities for management of patients in a high performing outpatient anticoagulation service.
  • Modify a patient’s anticoagulation therapy in the management of warfarin, low molecular weight heparin (LMWH) and direct oral anticoagulant (DOAC) medications in an outpatient anticoagulation service.
  • Summarize how to document care in the management of medications in an outpatient anticoagulation service.

Oral Direct Thrombin Inhibitors (DTI), Anti-Xa Agents, and Atrial Fibrillation
0204-0000-21-719-H01-P

  • Compare appropriate clinical and patient specific characteristics for DOAC and warfarin therapy.
  • Identify potential organ system and drug interactions with DOACs.
  • Design appropriate management strategies for a patient with organ system and drug interaction with DOACs.
  • Develop a plan to successfully convert a patient from warfarin to a DOAC.
  • Categorize an atrial fibrillation patient’s risk of stroke and bleeding in order to make treatment decisions.
  • Develop an individualized anticoagulation plan for a patient with atrial fibrillation.
  • Describe anticoagulation considerations related to ablations and anticoagulation alternatives in atrial fibrillation.

Anticoagulation in Special Populations
0204-0000-21-720-H01-P

  • Describe skills required by a pharmacist to assess if a patient requires special management considerations.
  • Design monitoring parameters for a patient within a special population receiving an anticoagulant.
  • Describe how factors for patients within special populations can alter risk for bleeding or thrombosis independent of direct effects on the anticoagulation regimen.
  • Compare outcomes in patients within a special population compared to ‘average’ patients.
  • Select appropriate anticoagulant therapy in a patient within a special population (obesity).
  • Select appropriate anticoagulant therapy in a patient within a special population (renal failure).
  • Select appropriate anticoagulant therapy in a patient within a special population (geriatric).
  • Discuss characteristics in pregnant women that put them at higher risk for VTE.
  • Apply key components for managing a pregnant patient with a VTE before, during, and after delivery.
  • Apply components and activities for managing a pediatric patient requiring anticoagulation therapy for a VTE.

Mechanical Devices and Focus on the Acute Care Setting
0204-0000-21-721-H01-P

  • Discuss common, current medical devices that require anticoagulation.
  • Analyze a patient’s device-specific anticoagulation regimen.
  • Design a patient- and device-specific anticoagulation regimen.
  • Review common, current medical devices that require anticoagulation.
  • Explain challenges that can occur with anticoagulants in the acutely and critically ill patient.
  • Describe characteristics of effective anticoagulation management specific to acutely ill patient.
  • Summarize what a pharmacist needs to consider in adapting anticoagulant therapy to the acutely ill patient.

Heparin Induced Thrombocytopenia (HIT) Treatment and Hypercoagulable Conditions
0204-0000-21-722-H01-P

  • Describe the pathophysiology and approaches to recognize heparin-induced thrombocytopenia (HIT).
  • Discuss approaches to managing HIT.
  • Discuss how to initiate and manage anticoagulation therapy in HIT.
  • Discuss how to initiate and manage parenteral direct thrombin inhibitors.
  • Differentiate between the various hypercoagulable states considering appropriate laboratory testing and clinical presentation.
  • Develop a management plan to mitigate the risk of thrombosis for various hypercoagulable states.
  • Assess the role of cancer as a hypercoagulable state and the use of risk assessment scores to determine management strategies

Laboratory Assessments
0204-0000-21-723-H01-P

  • Explain analytical tests utilized in the assessment and management of anticoagulant agents.
  • Summarize the limitations of anticoagulant assays.
  • Design an anticoagulation management plan that incorporates assays for decision support.

Reversing Anticoagulation and Peri-Operative Management
0204-0000-21-724-H01-P

  • Describe potential bleeding challenges during anticoagulation therapy.
  • Design an anticoagulation agent-specific reversal plan.
  • Summarize available anticoagulant medications and ways to reverse their effects.
  • Describe the various agents used to reverse anticoagulant effects.
  • Summarize invasive procedures and related risks for bleeding and thrombotic complications.
  • Design an anticoagulation management approach when an invasive procedure is planned.
  • Analyze a patient’s specific anticoagulation regimen and estimate when effects may be absent.

Skills for Managing Anticoagulation Therapy
0204-0000-21-725-H04-P

  • Discuss the skill set needed for initiating and developing anticoagulation therapy management plans.
  • Describe skills for assessing and adjusting anticoagulation management plans.
  • Re-define a pharmacist’s role in managing anticoagulation therapy.
  • Name key concepts learned in managing anticoagulation therapy.
  • Prepare a plan for continued self-development to evolve as an anticoagulation therapy provider.
  • Summarize a pharmacist’s role in managing anticoagulation therapy.
  • Apply concepts learned in managing anticoagulation therapy.
  • Prepare a plan for continued self-development to evolve as an anticoagulation therapy provider.

Learning Activity

ACPE Number

Contact Hours

Introduction to Anticoagulation

0204-0000-21-714-H04-P

2.25

Arterial Disease and Venous Thromboembolism Treatment

0204-0000-21-716-H01-P

2.75

Thrombolytic Therapy

0204-0000-21-717-H01-P

2.25

Warfarin and Focus on the Ambulatory Setting

0204-0000-21-718-H01-P

2.75

Oral Direct Thrombin Inhibitors (DTI), Anti-Xa Agents, and Atrial Fibrillation

0204-0000-21-719-H01-P

2.75

Anticoagulation in Special Populations

0204-0000-21-720-H01-P

3.50

Mechanical Devices and Focus on the Acute Care Setting

0204-0000-21-721-H01-P

2.50

Heparin-Induced Thrombocytopenia: Pathophysiology and Recognition

0204-0000-21-722-H01-P

2.75

Laboratory Assessments

0204-0000-21-723-H01-P

2.00

Reversing Anticoagulation and Peri-Operative Management

0204-0000-21-724-H01-P

3.50

Skills for Managing Anticoagulation Therapy

0204-0000-21-725-H04-P

2.25

  →  Final Assessment: 80% passing score

Craig J. Beavers, Pharm.D., BCCP, BCPS-AQ Cardiology, CACP, FACC, FAHA, FCCP
Director of Cardiovascular Services
Baptist Health Paducah
Cardiovascular Clinical Pharmacist
University of Kentucky Healthcare
Adjunct Assistant Professor, Department of Pharmacy Practice and Science
University of Kentucky College of Pharmacy
Lexington, Kentucky

William E. Dager, Pharm.D., BCPS-AQ Cardiology, FASHP, FCCM, FCCP, FCSHP, MCCM
Pharmacist Specialist
University of California, Davis Health System
Clinical Professor of Pharmacy
UC San Francisco School of Pharmacy
Clinical Professor of Medicine
UC Davis School of Medicine
Sacramento, California

Candice Garwood, Pharm.D., BCACP, BCPS, FCCP
Clinical Professor, Department of Pharmacy Practice
Wayne State University Eugene Applebaum College of Pharmacy and Health Sciences
Ambulatory Care Clinical Pharmacy Specialist
Harper University Hospital
Detroit Medical Center
Detroit, Michigan

Michael P. Gulseth, Pharm.D., BCPS, FASHP, FMSHP
Program Director for Anticoagulation Services
Sanford University of South Dakota Medical Center
Clinical Associate Professor
University of South Dakota Sanford School of Medicine
Sioux Falls, South Dakota

Tadd Hellwig, Pharm.D., BCPS, FASHP
Professor, Department of Pharmacy Practice
South Dakota State University College of Pharmacy and Allied Health Professions
Brookings, South Dakota
Clinical Pharmacist
Sanford USD Medical Center
Sioux Falls, South Dakota

Hahyoon Kim, Pharm.D., BCCP
Clinical Pharmacist
University of California, Davis Health System
Sacramento, California

Keri S. Kim, Pharm.D., M.S. CTS, BCPS
Clinical Assistant Professor
University of Illinois at Chicago College of Pharmacy
Clinical Pharmacist
University of Illinois Hospital
Chicago, Illinois

Tyree H. Kiser, Pharm.D., BCPS, FCCM, FCCP
Professor
University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences
University of Colorado Anschutz Medical Campus
Clinical Pharmacy Specialist – Critical Care
University of Colorado Hospital
Aurora, Colorado

Anne E. Rose, Pharm.D.
Manager Patient Care Services: Anticoagulation Stewardship, Cardiology and Internal Medicine
University of Wisconsin Hospital and Clinics - UW Health
Madison, Wisconsin

Jessica Rimsans, Pharm.D., BCPS
Hemostatic and Antithrombotic Stewardship
Clinical Pharmacy Specialist
Brigham and Women’s Hospital
Boston, Massachusetts

Aaron Josh Roberts, Pharm.D., AACC, BCCP, BCPS-AQ Cardiology
Senior Clinical Pharmacist
University of California, Davis Health System
Associate Clinical Professor of Pharmacy, Volunteer
UC San Francisco School of Pharmacy
Associate Clinical Professor of Medicine, Volunteer
UC Davis School of Medicine
Sacramento, California

Nancy L. Shapiro, Pharm.D., BCACP, CACP, FCCP
Clinical Professor, Department of Pharmacy Practice
University of Illinois at Chicago College of Pharmacy
Coordinator and Clinical Pharmacist, Antithrombosis Clinic
Director, PGY2 Ambulatory Care Pharmacy Residency
University of Illinois Hospital and Health Sciences System
Chicago, Illinois

Toby C. Trujillo, Pharm.D., BCPS-AQ Cardiology, FAHA, FCCP
Associate Professor
University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences
Clinical Pharmacy Specialist – Anticoagulation/Cardiology
University of Colorado Hospital
Aurora, Colorado

Ellen M. Uppuluri, Pharm.D., BCACP, CACP
Clinical Assistant Professor
University of Illinois at Chicago College of Pharmacy
Chicago, Illinois

In accordance with ACCME and ACPE Standards for Commercial Support, ASHP requires that all individuals in a position to control the content of this activity disclose financial relationships with ACCME-defined commercial entities. An individual has a relevant financial relationship if he or she (or spouse/domestic partner) has a financial relationship, in any amount, occurring in the past 12 months with a commercial entity whose products or services will discussed in the activity.

In this activity, only the individual(s) below have a relevant financial relationship:

  • Michael P. Gulseth, Pharm.D., BCPS, FASHP, FMSHP - Serves on the speaker’s bureaus for Janssen Pharmaceuticals, Inc., Bristol Myers Squibb, Pfizer Inc., CSL Behring, Portola Pharmaceuticals, Inc., and Diagnostica Stago, Inc.

All other ASHP staff, planners, faculty, reviewers, and subject matter expertsreport no financial relationships relevant to this activity.

This online activity consists of a combined total of 12 learning modules. Pharmacists are eligible to receive a total of 32 hours of continuing education credit by completing all 12 modules within this certificate program.

Participants must participate in the entire activity, complete the evaluation and all required components to claim continuing pharmacy education credit online at ASHP eLearning Portal http://elearning.ashp.org. Follow the prompts to claim credit and view your statement of credit within 60 days after completing the activity.

Important Note – ACPE 60 Day Deadline: Per ACPE requirements, CPE credit must be claimed within 60 days of being earned – no exceptions! To verify that you have completed the required steps and to ensure your credits have been reported to CPE Monitor, we encourage you to check your NABP eProfile account to validate your credits were transferred successfully before the ACPE 60-day deadline. After the 60 day deadline, ASHP will no longer be able to award credit for this activity.