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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Apr 20, 2026, 12:14Yanki Yarman: Linking Genetic Variants to Clinical Outcomes in Thrombosis
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Apr 20, 2026, 12:09Syed Sibtain Raza: White Blood Cells – Understanding Morphology for Better Diagnosis
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Apr 20, 2026, 11:23Bastu Odoka: Jehovah’s Witness News on Transfusion… and a Question Worth Asking
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Apr 20, 2026, 11:15William Aird: A Physiological Approach to Anemia
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Apr 20, 2026, 10:59Eric Topol: Is the Interferon Pathway a Key Driver of Inflammaging and Aging
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Apr 20, 2026, 10:47Emmanuel J Favaloro: Emerging Perspectives on Extracellular Vesicles in Hemophilia
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Apr 20, 2026, 10:21Pierpaolo Di Micco: Honored to Join the ESVM Congress in Lausanne
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Apr 20, 2026, 08:17Heghine Khachatryan: Key Takeaways from Day 1 – WFH 2026 World Congress
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Apr 20, 2026, 08:10Justin Nelson-Deering։ Celebrating World Hemophilia Day in Pediatric Care