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Effects of Direct Oral Anticoagulants on Coagulation Testing

Written by Mark Hill on .

The Direct oral anticoagulants (DOACs) require no laboratory monitoring, however the BCSH guidelines acknowledge that there may be circumstances where measurement of the concentration of the active drug or its effect may facilitate clinical management decisions (Kitchen et.al 2014). Each DOAC will interfere with almost all clotting tests to a varying degree, depending on the DOAC, assay principles and reagents used.

In order to aid with interpretation of coagulation assays when a DOAC is present in the patients plasma see this guide to illustrate the impact of DOACs on assays used within University Hospitals NHS Trust.

 If further advice is required please speak to Haematology.

 Measurement of non-coumarin anticoagulants and their effects on tests of Haemostasis: Guidance from the British Committee for Standards in Haematology. Steve Kitchen, Elaine Gray, Ian Mackie, Trevor Baglin and Mike Makris, on behalf of the BCSH committee. British Journal of Haematology, 2014, 166, 830–841.

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Edoxaban Assay

Written by Mark Hill on .

Edoxaban is one of the direct oral anticoagulants, exerting an anticoagulant effect by inhibiting activated factor X.

Changes in the prothrombin time (PT), international normalized ratio (INR), and activated partial thromboplastin time (aPTT) may be observed in patients on therapeutic edoxaban doses. However, these changes tend to be small, unpredictable, and highly variable, so clinicians should not use these markers to monitor the anticoagulant effects or titrate the dose of edoxaban (Plitt A, Giugliano RP. Edoxaban: review of Pharmacology and key phase I to III clinical trials. J Cardiovasc Pharmacol Ther. 2014;19(5):409–416).

Urgent requests should be discussed with the laboratory prior to receiving the sample.

This test will be reviewed by UKAS for ISO 15189 accreditation at the next surveillance visit in October 2019

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Gaucher's Disease

Written by Mark Hill on .

For advice on the investigation and diagnosis of Gaucher's Disease including contact details for referral of positive patients click here

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General Information

The laboratories at Heartlands Hospital, Good Hope Hospital and Solihull Hospital form part of the services provided by University Hospitals Birmingham and are UKAS (United Kingdom Accreditation Service) accredited to the ISO 15189:2012 standard. For a list of accredited tests and other information please visit the UKAS website using the following link: https://www.ukas.com/find-an-organisation/

  • Heartlands, Good Hope and Solihull Hospital pathology laboratories are a UKAS accredited medical laboratory No.8217
  • United Kingdom Health Security Agency laboratory is a UKAS accredited medical laboratory No.8213

Tests not appearing on the UKAS Schedule of Accreditation currently remain outside of our scope of accreditation. However, these tests have been validated to the same high standard as accredited tests and are performed by the same trained and competent staff.

For further test information, please visit the test database: http://www.heftpathology.com/frontpage/test-database.html.

Protection of personal information - Laboratory Medicine comply with the Trust Data Protection policy and have procedures in place to allow the Directorate and its employees to comply with the Data Protection act  1998 and associated best practice and guidance.

For further information contact Louise Fallon, Quality Manager, 0121 424 1235

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