Anticoagulation Management Services
Kaiser Permanente Anticoagulation Management Services (AMS) has a proven track record of managing long-term, short-term, and bridge anticoagulation therapies. Washington Medical Group physicians can refer patients to us — services are available to patients across Washington state.
Our AMS team will partner with you to:
- Increase patient lab testing compliance
- Improve patient safety
- Optimize efficacy of therapy
- Decrease risk of adverse events
How our program works
Our AMS program is built around the patient, with a telephone-based approach for outreach and consultation. Your patients can work with us from the comfort of their homes, saving them the time and expense of having to come in for face-to-face visits. This level of convenience means they'll be more likely to comply with treatment, which gives you the best odds for successful therapy.
Standardized, evidence-based protocols include rigorous monitoring and follow-up from staff at our centralized AMS office, where our specialty teams work closely together. Patients can have lab testing done at any lab services provider, including Kaiser Permanente medical office labs. Patients using warfarin can have INR testing done at these same lab services, or they can test INR themselves using a home monitoring device.
Service highlights
- New patient welcome and onboarding
- Evaluation of health history, current medications, and diet
- Anticoagulation agent and dose selection
- Patient education about anticoagulation therapy and individual treatment plans
- Nutrition and lifestyle recommendations
- INR and Serum creatinine monitoring with adjustments of medication or testing frequency
- Ongoing evaluation of changes in diet or other medications that could affect therapy
- Assessment of acute illness that could affect therapy
- Review of patient adherence and interventions to improve patient engagement
- 24/7 clinical support to answer patient questions and intake patient information
Team approach to care
Our AMS program staff includes pharmacists, nurses, and medical assistants who are specially trained in anticoagulant therapy. Clinical teams work closely together on defined panels of patients.
Life-saving TTR results
The percentage of time warfarin patients register within therapeutic testing ranges (TTR) is a key indicator for efficacy of therapy. Our patients' average for TTR is 77 percent; that's 12 percentage points higher than the national average of 65 percent.*
The clinical benefits of increased TTR are significant, as documented in a study published in the American Heart Association's Circulation journal:**
- With a 7 percent increase in TTR, 1 patient out of 100 is saved from major hemorrhage
- With a 12 percent increase in TTR, 1 patient out of 100 is saved from a thromboembolic event
Based on these study results, our AMS program, which cares for approximately 4,000 warfarin patients, will save an additional 114 people (over and above the national average) from these tragic adverse events.
*Kaiser Permanente internal report, 2023 Q2
**Yi Wan et al., "Anticoagulation Control and Prediction of Adverse Events in Patients with Arial Fibrillation: A Systemic Review," Journal of the American Heart Association, Circulation, Cardiovascular Quality Outcomes. 2008:1:84-91
Medication Adherence
Medications are only effective if taken regularly as prescribed. Medication adherence can be assessed by the measure of the Portion of Days Covered or PDC. PDC refers to an individual patient possession of medication of 80% of the time or more based on prescription refill history. KPWA adherence rates for the direct oral anticoagulants (DOACs) are among the highest of all of the KP regions at 84 percent.