COVID-19 – Guidance for Safe Switching of Warfarin to DOACs

Please see attached Guidance for the safe switching of warfarin to direct oral anticoagulants (DOACs) for patients with non-valvular AF and venous thromboembolism (DVT / PE) during the coronavirus pandemic – endorsed by Royal College of General Practitioners, British Haematology Society, Royal Pharmaceutical Society, UK Clinical Pharmacy Association, Primary Care Pharmacy Association & the Primary Care Cardiovascular Society.

The Guidance is accompanied by the following statement from the Atrial Fibrillation Leads for the Academic Health Science Network, Professor Gary Ford (Professor of Stroke Medicine, University of Oxford) & Helen Williams (National Clinical Adviser for AF):

We are aware that many general practitioners are switching patients on warfarin to DOACs to reduce the need for face to face contact with INR checks.  Whilst the benefits of this are clear in the current COVID crisis it is important that this is undertaken in a safe way and not applied to patients who are unsuitable for DOACs. Whilst awaiting the broader guidance, a number of associations and societies across the UK have come together to provide guidance on the safe switching of warfarin to DOACs  This needs to be undertaken in a phased manner over the 12 week cycle of INR monitoring to protect the supply chain of anticoagulants for ALL patients.  As highlighted, many patients are not suitable for a switch from warfarin to DOACs and further guidance will be available shortly to support services providing care for these patients please see the following link: https://www.rpharms.com/development/coronavirus-cpd-resources#warfarindoac.

Self-testing with CoaguChek may be an option for those patients who must remain on warfarin.

FINAL-Guidance-on-safe-switching-of-warfarin-to-DOAC-COVID-19-Mar-2020