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 20, 2026, 16:51Suzan Nakasendwa: A Growing Stroke Challenge in Uganda
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Oct 20, 2026, 16:38Steve Moon: How Does Smoking Cessation Duration Affect Ischemic Stroke Risk
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Oct 20, 2026, 16:25Cedrice Mentor: Reducing Platelet Wastage Through Cold Storage
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Oct 20, 2026, 16:09Thirunavukkarasu Angappan: Can a Purified Fibrinogen Concentrate Replace Cryoprecipitate
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Oct 20, 2026, 16:01Kalyan Roy: Platelet Conservation Through Evidence-Based Transfusion Practice
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Oct 20, 2026, 15:28Stacy E. Croteau: 33 Countries, One Mission – Better Bleeding Disorder Care
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Oct 20, 2026, 15:19Teresa Barnes: What Does a Pulmonary Embolism Mean for Jalen Hurts?
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Oct 20, 2026, 15:04Laura S.: Could Speaking Up Prevent Maternal Deaths from Thrombosis?
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Oct 20, 2026, 14:44Pete Stibbs: VTE in Professional Athletes – When Fitness Is Not Enough