Children's Community Nursing Service, Richmond
Anticoagulation medicines
Anticoagulant medicines are used to prevent a clot forming in your blood or to treat clots that have already formed.
There are various types of anticoagulation medicines:
- warfarin
- DOACs (direct oral anticoagulants) including Apixaban, Rivaroxaban, Dabigatran and Edoxaban
- Fragmin injections.
Anticoagulation clinic
The clinic supports adult patients who need anticoagulation treatment. Your doctor may have prescribed anticoagulation medicine for you, or they may have asked the clinic to start prescribing it for you.
The clinic advises patients on interruption of their anticoagulation medicine (bridging) prior to planned medical procedures.
It also supports and prescribes medicine for patients who have been advised they need anticoagulation medicine for long haul flights.
The clinic is run by clinical nurse specialists (CNS). The CNS team works alongside a consultant haematologist (a doctor with expertise in blood disorders).
First appointment
When you first attend the clinic you can expect the following.
Blood tests
Usually we ask patients to have a blood test before their first appointment. We will let you know when and where to have your blood test.
Your blood test results enable us to decide which form of anticoagulation medicine is best for you.
Anticoagulation medicine
We base our decision about which anticoagulation medicine to prescribe for you on various factors. These include the condition you have been diagnosed with, your blood test results or other underlying health issues.
A CNS will talk to you about your anticoagulation medicine and what you can expect while you are taking it. They will also give you an information booklet on the medicine you will be taking.
Finger prick testing
We offer finger prick testing for patients who are already on warfarin or who are likely to be prescribed with warfarin.
A finger prick tests means we prick your finger and test the blood from there, instead of taking blood from your arm. After a finger prick test we can give you the result straightaway.
A finger prick blood test only measures the amount of warfarin in your blood so it is not suitable for patients on Fragmin or DOAC medicine.
Where
Most first appointments are telephone consultations with a CNS. Sometimes the CNS may ask to see you in person.
We offer appointments on a Monday or Tuesday pm or a Wednesday or Friday am.
The clinic is in the Blood Test Department, Room 6. This is located in the Kingston Hospital Main Outpatients department.
We run bridging clinics everyday. These appointments are telephone only.
After first appointment
Patients on warfarin
We may see you several times at the start of your warfarin treatment.
If you are taking warfarin we will ask you to attend a follow up appointment on Monday morning or Thursday afternoon.
When your warfarin level is stable, we will transfer you to the ‘postal’ follow up appointment system. This system requires you to have a blood sample taken from your arm. The postal system gives you the freedom to have your blood taken at your GP practice or at Kingston Hospital on a specified day (but without the restrictions of a fixed appointment time).
Depending on the results of your blood test, the anticoagulation service will either ring you or post your results to you. They will give you information on what dose of warfarin to take and when you need to take your next blood test.
Patients on Fragmin
If you are on Fragmin injections only, you may not have to attend a follow up appointment.
Patients on DOACs
If you are on DOAC medicine we will give you a follow up appointment and will then transfer you to the care of your GP.
The CNS will be able to give you more information on any follow up appointments you may require.
Blood test records
The Anticoagulation Service will post you a copy of your blood test result and/or instructions on how much medicine you need to take.
This information will be in a ‘payslip’ format which contains your personal details, your results and dosing, and the request form for a further blood test.
When you attend the anticoagulation clinic, always bring this ‘payslip’ paper record. It will tell us if your GP or district nurse has been taking your blood.
Important information graphic
Keep a record of your blood tests and the amount of warfarin or Fragmin you are taking.
Always have a warfarin blood test when we ask you to do so.
Always have a warfarin blood test when we ask you to do so.
Contact information
Kingston Hospital anticoagulation clinic
Monday to Friday, 9am to 5pm
Telephone:
- For questions about medicines or treatment:
020 8934 2321 Option 5, ask for the nurse on duty - For appointment or admin questions:
020 8934 2321 Option 5
Email: khft.anticoag@nhs.net