MAPPP vs SMARTDM2

Despite the considerable efficacy of antithrombotics and the increased number of oral anticoagulants now available, preventable bleeding and thrombotic events are still unacceptably common. While recently marketed agents require less laboratory monitoring, problems with the clinical management of anticoagulated patients persist, particularly in the peri-procedural period. Surgery and invasive medical interventions increase the risk of bleeding, while withholding anticoagulants increases the risk of thrombosis due to the underlying condition(s) for which anticoagulation was originally prescribed. The clinical team must therefore balance these competing risks and make educated decisions regarding the decision to interrupt oral anticoagulation for a medical procedure and, if interrupted, whether to "bridge" anticoagulation with injectable anticoagulants, such as low molecular weight heparin (LMWH) in warfarin treated patients. This guide is intended to: -Assist clinicians in the simultaneous evaluation of procedure-related bleeding risk and underlying risk of thrombosis -Guide decisions regarding the interruption of anticoagulation and the use of anticoagulant "bridging" -Provide detailed guidance for drug dosing and laboratory monitoring in the peri-procedural period -Encourage clear communication between clinicians involved in prescribing anticoagulants and performing invasive procedures This material was created by the multidisciplinary members of the Peri-Procedural Task Force of the New York State Anticoagulation Coalition and IPRO, the Medicare Quality Improvement Organization for New York State, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The contents do not necessarily reflect CMS policy. 10SOW-NY-AIM-7.3-14-01

The management of outpatient antihyperglycemic regimens for patients with type 2 diabetes is complicated. This app is designed to synthesize treatment pathway guidelines developed by the American Diabetes Association, the American Association of Clinical Endocrinologists / American College of Endocrinology, and the Emory University Diabetes Council. Based on patient-specific factors that you select, a weighted list of medication options is sorted and presented. Designed for use by healthcare professionals. We have no relationship with nor has the app been endorsed by the American Diabetes Association, the American Association of Clinical Endocrinologists or the American College of Endocrinology. Results from the app should not be considered medical advice: individual patient factors not accounted for in the app may influence management decisions; medical evidence and guidelines may change ahead of updates to the app; regardless of best efforts, errors may be present in the app. Consult your doctor before making any changes to your medication regimen.