Life-Threatening Bleeding in the Anticoagulated Patient: Real World Evidence

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The Life-Threatening Bleeding in the Anticoagulated Patient Journal Club: Real World Evidence for Effectiveness

Life-Threatening Bleeding in the Anticoagulated Patient: Real World Evidence

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  • Overview

    Patients presenting to the hospital with severe bleeding and underlying treatment with Factor Xa (FXa) or Factor IIa inhibitors represent an enormous challenge to providers and clinicians since the approvals of apixaban, edoxaban, rivaroxaban, and dabigatran within the United States. Intracranial bleeding, intra-abdominal or thoracic trauma, gastrointestinal bleeding, and bleeding from any non-compressible source represent true life-threatening emergencies. Treatment of severe bleeding in patients receiving Factor Xa and Factor IIa inhibitors currently involves using non-specific therapy such as blood factor replacement - packed red blood cells (pRBCs), fresh frozen plasma, and platelets. With the development and approval of reversal agents, treatment of severe bleeding can now be specifically directed at the source of the coagulopathy combined with appropriate blood factor replacement. 

    Nationally recognized guidelines have provided clear direction on how best to manage these types of major bleeding events. While published guidelines are an important resource in helping direct how to appropriately intervene, the inherent clinical and system challenge is as follows: How do I justify and juxtapose the clinical rationale for using a reversal agent with the inherent cost associated with it with a lack of comparative head-to-head studies? Our assessment of learners suggests that knowledge and implementation gaps remain. As data emerge regarding innovative approaches to therapy and real-world evidence associated with the actual use of reversal and replacement agents, healthcare professionals need to be aware of the latest publications which utilize real-world data in specific life-threatening bleeds in anticoagulated patients. 

    This program focuses on the role of reversal agents in the presence of life-threatening bleeds while on an anticoagulant. It covers the most recent key real-world data published relative to the use of reversal or repletion strategies in anticoagulated patients. 

    Please stay tuned for additional content to this program available for credit. MedEd On The Go will track the episodes you watch and provide you with the option to claim credit once you have reached the level of participation needed in order to claim. The maximum amount of credits available for the entire activity is 1.5

  • Target Audience

    This activity has been designed to meet the educational needs of the interprofessional team, including neurologists, emergency medicine, trauma, gastroenterologists, hematologists, critical care, intensivists, cardiologists, hospital medicine, surgeons (general, vascular, and cardiothoracic), nurse practitioners, physician assistants, nurses, and pharmacists as well as other clinicians involved in the management of life-threatening bleeds in the presence of an anticoagulant.

  • Learning Objectives

    After participating in this educational activity, participants should be better able to: 

    • Evaluate recent practice-changing data that can be applied to practice in the presence of a life-threatening bleed in the presence of anticoagulation
    • Apply the latest evidence-based approaches to maximize management prognostic outcomes for life-threatening bleeds in the presence of anticoagulation
  • Accreditation and Credit Designation Statements

    In support of improving patient care, this activity has been planned and implemented by Global Learning Collaborative (GLC) and Total CME, LLC. GLC is jointly accredited by the American Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC) to provide continuing education for the healthcare team.

    This activity was planned by and for the healthcare team, and learners will receive 1.5 Interprofessional Continuing Education (IPCE) credits for learning and change.

  • Faculty Disclosure of Commercial Relationships

    Disclosure Policy
    In accordance with the ACCME Standards for Integrity and Independence, Global Learning Collaborative (GLC) requires that individuals in a position to control the content of an educational activity disclose all relevant financial relationships with any ineligible company. GLC mitigates all conflicts of interest to ensure independence, objectivity, balance, and scientific rigor in all educational programs. 

    The following faculty have disclosed:

    W. Brian Gibler, MD, FACEP, FACC, FAHA, moderator for this educational event, is a board member/shareholder for Entegrion, Inc., and EMCREG-International; and is an advisor for Entegrion, Inc.   

    Paul P. Dobesh, PharmD, FACC, FAHA, FCCP, BCPS, BCCP, faculty for this educational event, receives consulting fees from Pfizer BMS Alliance, AstraZeneca, and  Janssen Pharmaceuticals.

    Gregory J. Fermann, MD, faculty for this educational event, is a contracted researcher for Siemens, InCarda, and Abbott; and receives consulting fees from AstraZeneca.

    Natalie Kreitzer, MD, MS,  faculty for this educational event, is a contracted researcher for the HeadSMART program by BrainBox; is a speaker for Alexion, an unaffiliated neurotrauma consultant for the National Football League; and a consultant for Entegrion.   

  • Planners and Managers Disclosure List

    The following planners/reviewers/managers have disclosed:

    W. Brian Gibler, MD, FACEP, FACC, FAHA, planner for this educational event, is a board member/shareholder for Entegrion, Inc., and EMCREG-International; and is an advisor for Entegrion, Inc.   

    William Mencia, MD, FACEHP, CHCP, reviewer for this educational event, has no relevant financial relationships with ineligible companies.

    Total CME, LLC. Planners and managers have no relevant commercial relationships to disclose.

    All the relevant financial relationships for these individuals have been mitigated.

  • Disclaimer

    The views and opinions expressed in this educational activity are those of the faculty and do not necessarily represent the views of GLC and Total CME, LLC. This presentation is not intended to define an exclusive course of patient management; the participant should use his/her clinical judgment, knowledge, experience, and diagnostic skills in applying or adopting for professional use any of the information provided herein. Any procedures, medications, or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient's conditions and possible contraindications or dangers in use, review of any applicable manufacturer’s product information, and comparison with recommendations of other authorities. Links to other sites may be provided as additional sources of information. Once you elect to link to a site outside of MedEd On The Go, you are subject to the terms and conditions of use, including copyright and licensing restrictions, of that site.

    Reproduction Prohibited
    Reproduction of this material is not permitted without written permission from the copyright owner.

  • Acknowledgment

    This activity is supported by an independent educational grant from AstraZeneca. 

    Jointly provided by Global Learning Collaborative (GLC), EMCREG-International, and Total CME, LLC.

  • Instructions for Completion

    During the period 3/31/2023 through 3/31/2024, registered participants wishing to receive continuing education credit for this activity must follow these steps:
    1. Read the learning objectives and faculty disclosures.
    2. Answer a pre-program question.
    3. View the program.
    4. Complete the post-test with a score of 100%. 
    5. Complete activity evaluation.
    6. Apply for credit and either bank your credits or print your certificate.

    For Pharmacists: Upon successfully completing the post-test with a score of 100% and the activity evaluation form, transcript information will be sent to the NABP CPE Monitor Service. This may require you to add or update the e-profile ID/date of birth information saved in your account.

  • System Requirements

    Our site requires a computer, tablet, or mobile device and a connection to the Internet. For best results, a high-speed Internet connection is recommended (DSL/Cable/Fibre). We also recommend using the latest version of your favorite browser to ensure compliance with W3C standards, such as Chrome, Safari, Firefox, or Microsoft Edge.

  • Publication Dates

    Release Date:

    Expiration Date: Ongoing Program - Expiration date will be posted when all episodes are published.

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Schedule29 Sep 2023