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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Oct 21, 2026, 07:15Mahmoud Saad: Successful Mechanical Thrombectomy for Right Atrial Thrombosis
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Oct 21, 2026, 06:55Hunain Shahbaz: Extended Dual Antiplatelet Therapy Beyond 12 Months After Drug-Eluting Stent Implantation
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Oct 21, 2026, 06:19Dawood Findakly: When Should Anticoagulation Be Held or Resumed?
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Oct 21, 2026, 03:36Steve Watson: Ligand Epitope Ratios Influence Antagonist Inhibition
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Oct 21, 2026, 03:18Stephen D. Coombs: Superficial Venous Thrombosis in Athletes and Importance of Early Recognition and Referral
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Oct 21, 2026, 02:52Aymar Akilimali: Bleeding During Anticoagulation as a Potential Signal of Occult Cancer
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Oct 21, 2026, 00:58Anees Ur Rahman: Completing a Two-Week Clinical Rotation at Haemophilia Treatment Centre Rawalpindi
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Oct 21, 2026, 00:56Caitlyn Mooney: Pulmonary Embolism in Athletes, Recognition and Return to Sport
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Oct 21, 2026, 00:54Hani Karrar: Pleased to Share Our Review on Emicizumab in Hemophilia A Management