Multilevel Stewardship Intervention for Use of Anticoagulation-Antiplatelet Therapy

Is use of a multicomponent antithrombotic stewardship initiative associated with reduced antiplatelet use in patients prescribed direct oral anticoagulants?In this quality improvement study including 7 intervention sites (27 588 patients) and 128 control sites (253 085 patients), the interventions were associated with a decrease in antiplatelet use by −0.6 percentage points per 6 months overall and −2.1 percentage points in patients with stable coronary artery disease.Results of this study suggest that these scalable multilevel interventions could result in clinically meaningful reductions in potentially harmful combination antithrombotic therapy.

Corresponding Author: Jacob E. Kurlander, MD, MS, VA Center for Clinical Management Research, VA Ann Arbor Healthcare System (152), PO Box 130170, Ann Arbor, MI 48113-0170 (jkurland@umich.edu).

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