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News
Many patients stay on both an anticoagulant and an antiplatelet long after the original reason has passed — raising their bleeding risk with little added benefit. A new VHA study found that a coordinated stewardship program combining clinician education, EHR changes, and pharmacist alerts significantly reduced unnecessary dual therapy. Experts say hospital admissions are a prime opportunity to catch and correct these outdated regimens.
Plenty of patients are walking around on both a blood thinner (like a DOAC) and an antiplatelet (like aspirin) well past the point where the combination makes sense. The original indication — say, a coronary stent placed years ago — may have long since resolved, but the dual regimen quietly persists, often because no single physician feels empowered to stop what another started. The result? Elevated bleeding risk with diminishing protective benefit.
A 2026 JAMA Internal Medicine study put a structured fix to the test. Across seven Veterans Health Administration systems, a multilevel antithrombotic stewardship program — combining clinician and patient education, EHR modifications, and a pharmacist-facing dashboard alert — significantly cut unnecessary antiplatelet use among DOAC patients compared to 128 control sites. Experts note that hospital admissions are one of the best windows to surface and reassess these buried regimens before they cause harm.
By the Numbers:
Why it matters: Dual antithrombotic therapy that outlasts its purpose is a common, underrecognized source of preventable bleeding. A systematic, team-based approach — not individual clinician memory — is what it takes to consistently catch these cases.
