PB1013 - Educational Resources on Periprocedural Anticoagulation Management: A Systematic Review

Tuesday, July 12, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: In-Person

Co-Author(s)

JB

Joanne M. Britto

Resident Physician
McMaster University
Hamilton, Ontario, Canada
AA

Abdullah Alshenaiber

Undergraduate student
McMaster University
Hamilton, Ontario, Canada
NC

Nathan Cantor

Medical Student
McMaster University
Hamilton, Ontario, Canada
AC

Andrew Chen

Medical Student
McMaster University
Hamilton, Ontario, Canada
PG

Patrick Grzela

Medical Student
McMaster University
Hamilton, Ontario, Canada
SS

Shadi Sadeghian

Medical Student
McMaster University
Hamilton, Ontario, Canada
DS

Devika Singh

Medical Student
McMaster University
Hamilton, Ontario, Canada
CZ

Cindy Zhang

Medical Student
McMaster University
Hamilton, Ontario, Canada
JD

James Douketis, MD

Physician
McMaster University/St. Joseph's Healthcare
Hamilton, Ontario, Canada
TC

Teresa M. Chan

Associate Professor of Medicine, Associate Dean of Continuing Professional Development
McMaster University
Hamilton, Ontario, Canada

Presenting Author(s)

Siraj Mithoowani, MD MHPE FRCPC

Assistant Professor
Department of Medicine, McMaster University, Hamilton, ON, Canada
Hamilton, Ontario, Canada

Background: Periprocedural anticoagulation management is a clinical problem encountered by physicians across all specialties however knowledge translation is incomplete, leading to avoidable patient harm. The breadth and quality of teaching resources in this domain have never been formally assessed.

Aims: We conducted a systematic review of peer-reviewed educational resources on periprocedural anticoagulation management to assess their quality and classify them according to an instructional design framework.

Methods: We searched OVID/MEDLINE, Embase and Web of Science for educational and review articles published between 2015 and 2021 on periprocedural management of patients on anticoagulants for any indication. Two reviewers independently screened studies for eligibility, extracted data (publication year, accompanying media, target audience) and assessed the educational quality using the revised METRIQ (rMETRIQ) score. Resources were classified as learning tasks, procedural information, supportive information, or part-task practice according to the Four-Component Instructional Design (4C/ID) model. This review was registered with PROSPERO.

Results: Of the 252 included articles, 97% were targeted to physicians, medical students, nurse practitioners or dentists. The target audience was made explicit in 135 articles (53.6%). 74% were targeted to Internal Medicine specialists and 53% to surgeons. Less than 5% of articles were targeted to Family Medicine or Emergency Medicine specialists. Common subtopics included direct oral anticoagulants, warfarin, atrial fibrillation, venous thromboembolism, bridging and anticoagulant reversal. 226 articles (89%) were of high-quality per the rMETRIQ score; 248 articles were classified as supportive information and 4 as procedural information.

Conclusion(s): Most peer-reviewed educational articles on periprocedural anticoagulation management were of high quality, however the great majority were supportive information. Very few resources were aimed at Family Medicine and Allied Health practitioners. Future educational publications should target a broader group of clinicians and take the form of just-in-time information, learning tasks (case studies), or part-task practice (practice items) to better situate them within a whole-task instructional design framework.