Abdul Mannan: A Practical Guide to Anticoagulation Stewardship
Abdul Mannan, Consultant Hematologist at Betsi Cadwaladr University Health Board, shared a post on LinkedIn:
“Most anticoagulation errors don’t happen because doctors don’t know the drugs.
They happen because nobody built a system around the prescription.
I’ve spent years watching patients bleed or clot because of one missing step.
The indication wasn’t documented. The renal function wasn’t rechecked. The duration was never reviewed.
Nobody asked: does this patient still need this?
That’s not a knowledge problem. That’s a stewardship problem.
So I built something to fix it.
My new Anticoagulation Stewardship reference covers everything in one place:
The 5R Framework:
- Right drug
- Right dose
- Right indication
- Right duration
- Right monitoring
DOAC vs Warfarin: Head-to-head comparison with renal dosing tables for apixaban, rivaroxaban, dabigatran and edoxaban
Risk scoring: CHA₂DS₂-VASc, HAS-BLED, Khorana — with the one teaching point about HAS-BLED that every trainee gets wrong
Step-by-step decision algorithm: From indication confirmation to monitoring plan
Reversal agents: Idarucizumab, andexanet alfa, PCC, protamine — with exact dosing and trial evidence
Stewardship checklist: For both initiation and every review visit
One thing I want you to remember:
A high HAS-BLED score is not a reason to stop anticoagulation in AF. It is a reason to fix the modifiable bleeding risks.
Treat the BP. Stop the NSAIDs. Switch to a DOAC if the INR is unstable.
The stroke risk almost always wins.
Built for trainees, juniors, nurses, pharmacists and anyone who touches an anticoagulant prescription.
What’s the anticoagulation stewardship gap you see most often in your practice?”
Other posts featuring Abdul Mannan on Hemostasis Today.
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Mar 4, 2026, 15:52Manik Madaan: Understanding 4 Hereditary Clotting Disorders
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Mar 4, 2026, 15:46Samwel Mikaye։ Key Insights on Stroke Types, Diagnosis, and Management
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Mar 4, 2026, 15:39Lu (Maggie) Qian: How Adaptive Trial Design Reveals Treatment Effects in COVID-19
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Mar 4, 2026, 15:30Pall T. Onundarson: Risks of Switching Warfarin to DOACs in Frail Elderly Patients with NVAF
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Mar 4, 2026, 15:25Mital Jhaveri: Key Updates in the 2026 Guideline on Acute Pulmonary Embolism in Adults
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Mar 4, 2026, 15:14Jean Terrier: The Relationship Between DOAC Plasma Concentrations and Clinical Outcomes
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Mar 4, 2026, 15:11Rishiraj Sinha: Why Trust Matters More Than Knowledge in Blood Donor Engagement
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Mar 4, 2026, 15:08Nico Gagelmann: Honored to Receive the Young European Hematology Association Award
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Mar 4, 2026, 14:45Rafael Demarchi Malgor: New Clinical Practice Guideline on Upper Extremity Deep Venous Thrombosis