Effects of Direct Oral Anticoagulants on Coagulation Testing

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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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.

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