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Available Strategies to Reverse Anticoagulation Medications

About this Course

UConn has developed web-based continuing pharmacy education activities to enhance the practice of pharmacists and assist pharmacists in making sound clinical decisions to affect the outcome of anticoagulation therapy for the patients they serve. There are a total of 12 hours of CPE credit available. Successful completion of these 12 hours (13 activities) or equivalent training will prepare the pharmacist for the Anticoagulation Traineeship, which described below in the Additional Information Box.

The activities below are available separately for $17/hr or as a bundle price of $140 for all 13 activities (12 hours). These are the pre-requisites for the anticoagulation traineeship. Any pharmacist who wishes to increase their knowledge of anticoagulation may take any of the programs below.

When you are ready to submit quiz answers, go to the Blue "Take Test/Evaluation" Button.

Target Audience

Pharmacists who are interested in making sound clinical decisions to affect the outcome of anticoagulation therapy for the patients they serve.

This activity is NOT accredited for technicians.

Pharmacist Learning Objectives

At the end of this application-based continuing education activity, the learner will be able to:

  1. Describe the pharmacological agents and therapeutic strategies available for use in patients who experience major bleeding.
  2. Discuss the risks and limitations of current agents available for reversal.
  3. Construct treatment plans to manage severe bleeding in a patient on anticoagulation therapy.

Release Date

Released:  06/01/2022
Expires:  05/31/2025

Course Fee

$17

ACPE UAN Code

ACPE #0009-0000-22-035-H01-P

Session Code

22AC35-WXY28

Accreditation Hours

1.0 hour of CE

Bundle Options

If desired, “bundle” pricing can be obtained by registering for the activities in groups. It consists of thirteen anticoagulation activities in our online selection.

You may register for individual topics at $17/CE Credit Hour, or for the Entire Anticoagulation Pre-requisite Series.

Pharmacist General Registration for 13 Anticoagulation Pre-requisite activities-(12 hours of CE)  $140.00

In order to attend the 2-day Anticoagulation Traineeship, you must complete all of the Pre-requisite Series or the equivalent.

Additional Information

Anticoagulation Traineeship at the University of Connecticut Health Center, Farmington, CT

The University of Connecticut School of Pharmacy and The UConn Health Center Outpatient Anticoagulation Clinic have developed 2-day practice-based ACPE certificate continuing education activity for registered pharmacists and nurses who are interested in the clinical management of patients on anticoagulant therapy and/or who are looking to expand their practice to involve patient management of outpatient anticoagulation therapy. This traineeship will provide you with both the clinical and administrative aspects of a pharmacist-managed outpatient anticoagulation clinic. The activity features ample time to individualize your learning experience. A “Certificate of Completion” will be awarded upon successful completion of the traineeship.

More Information About Traineeship

Accreditation Statement

ACPE logo

The University of Connecticut, School of Pharmacy, is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.  Statements of credit for the online activity ACPE #0009-0000-22-035-H01-P will be awarded when the post test and evaluation have been completed and passed with a 70% or better. Your CE credits will be uploaded to your CPE monitor profile within 2 weeks of completion of the program.

Grant Funding

There is no grant funding for this activity.

Requirements for Successful Completion

To receive CE Credit go to Blue Button labeled "take Test/Evaluation" at the top of the page.

Type in your NABP ID, DOB and the session code for the activity.  You were sent the session code in your confirmation email.

Faculty

Erin Emonds, PharmD
PGY-1 Pharmacy Practice
UConn Health Center
Farmington, CT

Anuja Rizal, PharmD, RPh, CACP
Clinic Manager
UConn Health Center
Farmington, CT

Faculty Disclosure

In accordance with the Accreditation Council for Pharmacy Education (ACPE) Criteria for Quality and Interpretive Guidelines, The University of Connecticut School of Pharmacy requires that faculty disclose any relationship that the faculty may have with commercial entities whose products or services may be mentioned in the activity.

Drs. Emonds and Rizal has no relationship with an ineligible company and therefore has nothing to disclose.

Disclaimer

The material presented here does not necessarily reflect the views of The University of Connecticut School of Pharmacy or its co-sponsor affiliates. These materials may discuss uses and dosages for therapeutic products, processes, procedures and inferred diagnoses that have not been approved by the United States Food and Drug Administration. A qualified health care professional should be consulted before using any therapeutic product discussed. All readers and continuing education participants should verify all information and data before treating patients or employing any therapies described in this continuing education activity.

Program Content

Program Handouts

Post Test Evaluation

View Questions for Risk Management in Anticoagulation

1. Comparing 4-factor PCC to 3- Factor PCC, what factor is not included in the “3”?

  1. II
  2. VII
  3. IX
  4. X

2. We consider anticoagulation to have resolved fully after _____half-lives have lapsed:

  1. Four
  2. Five
  3. Six
  4. Two

3. What differentiates major bleeding vs. non-major?

  1. Hemodynamically unstable
  2. Requires transfusion ≥ 2 units
  3. Decrease of hemoglobin ≥ 2 g/dL
  4. All of the above

4. When reversing the effects of warfarin, vitamin K is not needed when administering FFP or KCentra

  1. True
  2. False

5. Which of the following routes of administration is not appropriate for a bleeding patient?

  1. IV
  2. SQ
  3. PO
  4. IM

6. The correct full dose of idarucizumab is:

  1. 5 gms
  2. 5 gms
  3. 5 gm
  4. 50 units/kg

7. In general, the maximum dose of vitamin K for warfarin reversal is:

  1. 5mg
  2. 10mg
  3. 15mg
  4. 20mg

8. What anticoagulation agent may utilize hemodialysis as a form of reversal?

  1. Apixaban
  2. Rivaroxaban
  3. Dabigatran
  4. Warfarin

9. What agent is specifically used to directly reverse the effect Rivaroxaban and Apixaban

  1. Idarucizumab
  2. 4-factor PCC
  3. Andexanet afla
  4. Phytonidione

10. True or False: Obtaining and administering reversal agents must not delay resuscitation and local hemostatic measures.

  1. True
  2. False

Developing an Anticoagulation Clinic

About this Course

UConn has developed web-based continuing pharmacy education activities to enhance the practice of pharmacists and assist pharmacists in making sound clinical decisions to affect the outcome of anticoagulation therapy for the patients they serve. There are a total of 12 hours of CPE credit available. Successful completion of these 12 hours (13 activities) or equivalent training will prepare the pharmacist for the Anticoagulation Traineeship, which described below in the Additional Information Box.

The activities below are available separately for $17/hr or as a bundle price of $140 for all 13 activities (12 hours). These are the pre-requisites for the anticoagulation traineeship. Any pharmacist who wishes to increase their knowledge of anticoagulation may take any of the programs below.

When you are ready to submit quiz answers, go to the Blue "Take Test/Evaluation" Button.

Target Audience

Pharmacists who are interested in making sound clinical decisions to affect the outcome of anticoagulation therapy for the patients they serve.

This activity is NOT accredited for technicians.

Pharmacist Learning Objectives

At the end of this knowledge-based continuing education activity, the learner will be able to:

  1. Discuss the benefits of establishing an anticoagulation clinic.
  2. List the steps required to establish and run and anticoagulation clinic.
  3. Describe the important aspects of operating an anticoagulation clinic.
  4. Describe the financial considerations of running an anticoagulation clinic.

Release Date

Released:  06/01/2022
Expires:  05/31/2025

Course Fee

$17

ACPE UAN Code

ACPE #0009-0000-22-031-H04-P

Session Code

22AC31-YXV46

 

Accreditation Hours

1.0 hour of CE

Bundle Options

If desired, “bundle” pricing can be obtained by registering for the activities in groups. It consists of thirteen anticoagulation activities in our online selection.

You may register for individual topics at $17/CE Credit Hour, or for the Entire Anticoagulation Pre-requisite Series.

Pharmacist General Registration for 13 Anticoagulation Pre-requisite activities-(12 hours of CE)  $140.00

In order to attend the 2-day Anticoagulation Traineeship, you must complete all of the Pre-requisite Series or the equivalent.

Additional Information

Anticoagulation Traineeship at the University of Connecticut Health Center, Farmington, CT

The University of Connecticut School of Pharmacy and The UConn Health Center Outpatient Anticoagulation Clinic have developed 2-day practice-based ACPE certificate continuing education activity for registered pharmacists and nurses who are interested in the clinical management of patients on anticoagulant therapy and/or who are looking to expand their practice to involve patient management of outpatient anticoagulation therapy. This traineeship will provide you with both the clinical and administrative aspects of a pharmacist-managed outpatient anticoagulation clinic. The activity features ample time to individualize your learning experience. A “Certificate of Completion” will be awarded upon successful completion of the traineeship.

More Information About Traineeship

Accreditation Statement

ACPE logo

The University of Connecticut, School of Pharmacy, is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.  Statements of credit for the online activity ACPE ACPE #0009-0000-22-031-H04-P will be awarded when the post test and evaluation have been completed and passed with a 70% or better. Your CE credits will be uploaded to your CPE monitor profile within 2 weeks of completion of the program.

Grant Funding

There is no grant funding for this activity.

Requirements for Successful Completion

To receive CE Credit go to Blue Button labeled "take Test/Evaluation" at the top of the page.

Type in your NABP ID, DOB and the session code for the activity.  You were sent the session code in your confirmation email.

Faculty

Anuja Rizal, Pharm.D., RPh, CACP
Anticoagulation Clinical Coordinator
University of Connecticut Health Center
Farmington, CT

Faculty Disclosure

In accordance with the Accreditation Council for Pharmacy Education (ACPE) Criteria for Quality and Interpretive Guidelines, The University of Connecticut School of Pharmacy requires that faculty disclose any relationship that the faculty may have with commercial entities whose products or services may be mentioned in the activity.

Dr. Rizal has no relationship with an ineligible company and therefore has nothing to disclose.

Disclaimer

The material presented here does not necessarily reflect the views of The University of Connecticut School of Pharmacy or its co-sponsor affiliates. These materials may discuss uses and dosages for therapeutic products, processes, procedures and inferred diagnoses that have not been approved by the United States Food and Drug Administration. A qualified health care professional should be consulted before using any therapeutic product discussed. All readers and continuing education participants should verify all information and data before treating patients or employing any therapies described in this continuing education activity.

Program Content

Program Handouts

Post Test Evaluation

View Questions for Developing an Anticoagulation Clinic

1) Which of the following is not an advantage of having an Anticoagulation Clinic?
a) Improved patient communication and follow up
b) Improved TTR ad better clinical outcomes
c) Consistent dosing and monitoring
d) Formalized patient education
e) None of the above

2) What characteristics are essential when selecting an Anticoagulation Clinic Medical Director?
a. Extensive anticoagulation knowledge base
b. Approachable and available
c. Helps achieve goals of the clinic
d. Strong advocate for the clinic
e. All of the above

3) What is an Anticoagulation Clinic’s primary goal?
a. Optimize safety and efficacy
b. Improve efficiency
c. Provide cost effective care
d. Improve pt. satisfaction

4) Which of the following is an advantage of a Pharmacist run Anticoagulation Clinic?
a) Able to draw venous samples
b) Autonomy in both dosing and billing
c) Extensive knowledge of warfarin’s pharmacokinetic and pharmacodynamic properties
d) Able to assess vital signs

5) What are the requirements of having a collaborative practice agreement run Anticoagulation Clinic?
a. Pharmacists are required to submit minimum monthly therapeutic summaries
b. Pharmacists may only enter into collaborative practice agreement with prescribers permissible under state law
c. The physician must have an established relationship with patient
d. The collaborative practice agreement needs to be renewed yearly for each patient
e. All of the above

6) What are ongoing costs of running an Anticoagulation Clinic?
a) Printer
b) Personnel salaries
c) Office furniture
d) Fax
e) Scanner

7) Which of the following clinic tasks MUST be performed by a pharmacist?
a. Schedule patient appointments in the clinic for initial visit, follow up INR visits and education visits
b. Interpret INR results by assessing patient specific factors and adjust warfarin dose as needed
c. Order supplies
d. Retrieve INR results either from an outside laboratory
e. Identify past due INR patients and address as per policies and procedures

8) What are the characteristics of an ideal anticoagulation software program?
a. Data integrity
b. IT support after clinic hours
c. Ability to trend data for individual patient
d. A and C

9) Anticoagulation clinic staff training should:
a. Be documented
b. Be provided in an appropriate learning environment
c. Involve real world situations
d. All of the above

10) What characteristics should you look for when selecting an anticoagulation clinic support staff?
a. Strong interpersonal skills
b. Strong computer and data entry skills
c. Previous anticoagulation knowledge
d. A & B

Pharmacist Reimbursement for Anticoagulation Services

About this Course

UConn has developed web-based continuing pharmacy education activities to enhance the practice of pharmacists and assist pharmacists in making sound clinical decisions to affect the outcome of anticoagulation therapy for the patients they serve. There are a total of 12 hours of CPE credit available. Successful completion of these 12 hours (13 activities) or equivalent training will prepare the pharmacist for the Anticoagulation Traineeship, which described below in the Additional Information Box.

The activities below are available separately for $17/hr or as a bundle price of $140 for all 13 activities (12 hours). These are the pre-requisites for the anticoagulation traineeship. Any pharmacist who wishes to increase their knowledge of anticoagulation may take any of the programs below.

When you are ready to submit quiz answers, go to the Blue "Take Test/Evaluation" Button.

Target Audience

Pharmacists who are interested in making sound clinical decisions to affect the outcome of anticoagulation therapy for the patients they serve.

This activity is NOT accredited for technicians.

Pharmacist Learning Objectives

At the end of this application-based continuing education activity, the learner will be able to:

  1. Identify the reimbursement issues with a pharmacist-run anticoagulation service or clinic.
  2. Describe the process for billing for anticoagulation services.
  3. Identify challenges and obstacles for reimbursement issues for anticoagulation services.
  4. Discuss solutions to the challenges of reimbursement for pharmacist-run anticoagulation services.

Release Date

Released:  06/01/2022
Expires:  05/31/2025

Course Fee

$8.50

ACPE UAN Code

ACPE #0009-0000-22-032-H04-P

Session Code

22AC32-XZY77

Accreditation Hours

0.5 hours of CE

Bundle Options

If desired, “bundle” pricing can be obtained by registering for the activities in groups. It consists of thirteen anticoagulation activities in our online selection.

You may register for individual topics at $17/CE Credit Hour, or for the Entire Anticoagulation Pre-requisite Series.

Pharmacist General Registration for 13 Anticoagulation Pre-requisite activities-(12 hours of CE)  $140.00

In order to attend the 2-day Anticoagulation Traineeship, you must complete all of the Pre-requisite Series or the equivalent.

Additional Information

Anticoagulation Traineeship at the University of Connecticut Health Center, Farmington, CT

The University of Connecticut School of Pharmacy and The UConn Health Center Outpatient Anticoagulation Clinic have developed 2-day practice-based ACPE certificate continuing education activity for registered pharmacists and nurses who are interested in the clinical management of patients on anticoagulant therapy and/or who are looking to expand their practice to involve patient management of outpatient anticoagulation therapy. This traineeship will provide you with both the clinical and administrative aspects of a pharmacist-managed outpatient anticoagulation clinic. The activity features ample time to individualize your learning experience. A “Certificate of Completion” will be awarded upon successful completion of the traineeship.

More Information About Traineeship

Accreditation Statement

ACPE logo

The University of Connecticut, School of Pharmacy, is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.  Statements of credit for the online activity ADD ACPE ACPE #0009-0000-22-032-H04-P will be awarded when the post test and evaluation have been completed and passed with a 70% or better. Your CE credits will be uploaded to your CPE monitor profile within 2 weeks of completion of the program.

Grant Funding

There is no grant funding for this activity.

Requirements for Successful Completion

To receive CE Credit go to Blue Button labeled "take Test/Evaluation" at the top of the page.

Type in your NABP ID, DOB and the session code for the activity.  You were sent the session code in your confirmation email.

Faculty

Michael Smith, Pharm.D., BCPS, CACP,
East Region Clinical Manager
Pharmacy Hartford Healthcare
William W. Backus Hospital
Norwich, CT

Faculty Disclosure

In accordance with the Accreditation Council for Pharmacy Education (ACPE) Criteria for Quality and Interpretive Guidelines, The University of Connecticut School of Pharmacy requires that faculty disclose any relationship that the faculty may have with commercial entities whose products or services may be mentioned in the activity.

Dr. Smith has no relationship with an ineligible company and therefore has nothing to disclose.

Disclaimer

The material presented here does not necessarily reflect the views of The University of Connecticut School of Pharmacy or its co-sponsor affiliates. These materials may discuss uses and dosages for therapeutic products, processes, procedures and inferred diagnoses that have not been approved by the United States Food and Drug Administration. A qualified health care professional should be consulted before using any therapeutic product discussed. All readers and continuing education participants should verify all information and data before treating patients or employing any therapies described in this continuing education activity.

Program Content

Program Handouts

Post Test Evaluation

View Questions for Pharmacist Reimbursement for Anticoagulation Services

1. Pharmacist, as recognized providers, can directly bill Medicare for services

  1. True
  2. False

 

2. Medicare can be billed for:

  1. Evaluation and management of an INR level
  2. Performing a finger-stick POC INR test
  3. Calling a patient to report their results
  4. A and B

 

3. The level of service for a clinic visit for HOPPS billing is

  1. Set to the same guidelines for “incident to billing”
  2. Set by institution policy
  3. Arbitrary
  4. Must be code “99211”

 

4. Physician supervision rules:

  1. are the same for both on and off-campus clinic sites
  2. pertain only to “incident to” billing
  3. May be satisfied by having an advanced practice nurse on site
  4. Increase the allowable billing level when they are followed

 

5. A point-of-care INR test:

  1. Can be billed separately as a lab procedure
  2. Must be performed by a lab technician in order to be billed
  3. Are not considered valid by Medicare
  4. Are not covered

Anticoagulation Traineeship – Certificate Program

The University of Connecticut School of Pharmacy and The UConn Health Center Outpatient Anticoagulation Clinic have developed 2-day practice-based ACPE certificate continuing education activity for registered pharmacists and nurses who are interested in the clinical management of patients on anticoagulant therapy and/or who are looking to expand their practice to involve patient management of outpatient anticoagulation therapy. This traineeship will provide you with both the clinical and administrative aspects of a pharmacist-managed outpatient anticoagulation clinic. The activity features ample time to individualize your learning experience. A “Certificate of Completion” will be awarded upon successful completion of the traineeship.

“I had a very successful and wonderful learning experience that I will treasure and WILL apply to my practice ASAP” – LKD

“ ….this is a great program and I do not have enough good things to say about Dr. Durman and Dr. Bui.  They have amalgamated the art of customer service and patient care and have integrated my traineeship into their routine without any issues. ” – LP

“.….very comprehensive 2 days. I was able to see a lot!” – MS

Target Audience

This certificate program is for registered pharmacists and nurses who are interested in the clinical management of patients on anticoagulant therapy and/or who are looking to expand their practice to involve patient management of outpatient anticoagulation therapy.

Traineeship Learning Objectives

At the conclusion of the 2 day traineeship, pharmacists will be able to:

  1. Conduct patients interviews
  2. Evaluate current medications as it relates to anticoagulation therapy
  3. Describe the proper technique for obtaining point-of- care INR testing
  4. Adjust anticoagulant therapy for a patient based on desired outcome
  5. Prepare a patient-specific monitoring plan
  6. Formulate a note for the patient’s chart outlining your assessment and plan
  7. Describe how to bill for services

Pre-Requisites

  1. All participants must successfully complete the 12-hour online training at pharmacy.uconn.edu/academics/ce/anticoagulation or an equivalent training as approved by the Director of CE and the faculty of the traineeship.
  2. All participants must have a valid pharmacist, MD or nursing license
  3. All participants must provide documentation of current professional liability insurance
  4. All participants must complete the application (below)
  5. A telephone interview will be conducted prior to day 1 to discuss goals and expectations of the A copy of clinic’s policy and procedures will also be forwarded to the participant prior to the visit. Participants are expected to be familiar with the clinic’s policy and point-of-care testing manual.

Location

UConn Health Outpatient Services Anticoagulation Clinic
11 SOUTH ROAD
FARMINGTON, CT 06030
Suite 230 MC 6237

Email your completed application and proof of liability insurance to joanne.nault@uconn.edu. Once received, UConn will contact you with the date of attendance.

Spring 2025 dates!
Tuesday and Wednesday – March 25-26, 2025
Tuesday and Wednesday – April 15-16, 2025
Monday and Tuesday – April 28-29, 2025
Wednesday and Thursday – May 14-15, 2025
Tuesday and Wednesday – June 3-4

 

Agenda for Traineeship

Day 1
8:30-9:00 am Orientation to the clinic and staff, HR forms, review clinic workflow
9:00 am-12:30 pm Observation of patient interview process, point-of-care testing, dose decision making, and documentation procedures.
12:30 pm-1:00 pm Lunch
1:00 pm-3:00 pm Observed patient interviews and documentation
3:00 pm-3:30 pm Observed telephone patient interviews, and documentation
3:30 pm-4:30 pm Day 1 review and evaluation
Day2
8:30 am-9:00 am Q/A in preparation for day’s work
9:00 am-12:30 pm Solo telephone patient interviews, and documentation.
12:30 pm -1:00 pm Lunch
1:00 pm-1:30 pm Review of morning’s work
1:30 pm-2:30 pm Solo patient interviews, and documentation.
2:30 pm-4:30 pm Wrap up Q/A, address individual needs and final evaluation.

Activity Faculty

Anuja Rizal, RPh, PharmD, CACP, John Dempsey Hospital Anticoagulation Clinic Coordinator, Farmington, CT

Elizabeth Biron, PharmD, John Dempsey Hospital Anticoagulation Clinic Pharmacist, Farmington, CT

Damian Green, Pharmacy Technician, John Dempsey Hospital Anticoagulation Clinic, Farmington, CT

Faculty Disclosure

In accordance with the Accreditation Council for Pharmacy Education (ACPE) Criteria for Quality and Interpretive Guidelines, The University of Connecticut School of Pharmacy requires that faculty disclose any relationship that the faculty may have with commercial entities whose products or services may be mentioned in the activity.

Dr. Rizal does not have anything to disclose.

Dr. Biron does not have anything to disclose.

Activity Fees

Prerequisite Online content: can be found at www.pharmacy.uconn.edu/academics/ce/anticoagulation click on each of the listed activities to register.  If you register for the entire bundle, the pricing is discounted to $140 total rather than approximately $17/credit hour.

Live  content:  Please see above for available traineeship dates.  These dates are filled on a first come/first serve basis.

The Registration Fee of $500 includes all costs of the traineeship instruction and printed materials, but does not include the home study pre-requisites.

APPLICATION

Please call Joanne at 860-486-2084 with credit card information. Scan and email your completed application to the address below.

joanne.nault@uconn.edu

There is no reduced fee for UConn faculty, adjunct faculty,  preceptors or volunteers for this program

Refunds

The registration fee, less a $75 processing fee, is refundable for those that cancel their registration more than 14 days prior to your scheduled live program. After that time, no refund is available. Participant substitutions may be made at any time.

    Grant Funding

    There is no grant funding for this activity.

      ACPE logo

      The University of Connecticut, School of Pharmacy, is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. Sixteen contact hours (1.6 CEU’s)  of practice-based certificate continuing education credit for pharmacists who participate in the traineeship and pass the competency evaluation with at least a “3” in all of the assessment categories. Credit will be automatically uploaded to the CPE Monitor system, and a certificate of completion will be mailed within 4 weeks of traineeship completion. UAN#0009-0000-23-003-L01-P

      Initial release date:  March 16, 2023
      Planned expiration date:  March 16, 2026

      Disclaimer:
      The material presented here does not necessarily reflect the views of The University of Connecticut School of Pharmacy or its co-sponsor affiliates. These materials may discuss uses and dosages for therapeutic products, processes, procedures and inferred diagnoses that have not been approved by the United States Food and Drug Administration. A qualified health care professional should be consulted before using any therapeutic product discussed. All readers and continuing education participants should verify all information and data before treating patients or employing any therapies described in this continuing education activity.