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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Jun 1, 2026, 15:24John Chuback: DVT Can Start With Symptoms Many People Brush Off
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Jun 1, 2026, 15:20Venugopalan Unni: Guidelines for the Evaluation and Management of Acute Pulmonary Embolism in Adults
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Jun 1, 2026, 15:10Smitirupa Mishra: Standardizing RBC Morphology Reporting – Why ICSH Guidelines Matter?
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Jun 1, 2026, 14:54Davide Massimi: A Bloodless Approach to Third Space Endoscopy
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Jun 1, 2026, 14:27Afshan Sumera: Plasma Proteomics Reveals Complement And Coagulation Disruption In Transfusion-Dependent Thalassemia
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Jun 1, 2026, 13:44Milad Abdalla: Elevating Phlebotomy Standards – Why Order of Draw and Blood Cultures Matter
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Jun 1, 2026, 13:39Abdul Mannan: The Moral Injury of Practising Haemato-Oncology in a Resource-Limited Setting
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Jun 1, 2026, 13:34Filza Aslam: What Does a Patient Journey Partner Actually Do in Bleeding Disorders?
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Jun 1, 2026, 13:33Darine Ghanem: Advancing Health Equity in Care at the LATAM Meeting