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Journal de Pharmacie Clinique

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Anticoagulants in frail patients: 7 high-risk patient groups Volume 36, issue 4, Décembre 2017

Authors
1 Service d’hématologie, Hôpital Tenon, Paris, France
2 Service de gériatrie, Hôpital Broca, Paris, France
3 Service ICAR, Hôpital de la Pitié-Salpêtrière, Paris, France
4 Service de néphrologie, Hôpital de la Pitié-Salpêtrière, Paris, France
* Tirés à part

In the case of venous thromboembolic disease (VTE), physicians are more and more facing the difficulties of managing VTE and their treatment in frail patients. These patients could present several at risk situation such as: chronic kidney disease (CKD), underweight or malnourished, falls, cognitive impairment, multi-medicated patients, cancer and pregnancy. Guidelines typically recommend anticoagulation. There are multiple challenges in the safe use of anticoagulation in frail patients, including bleeding risk, monitoring and adherence, and polypharmacy. The objective of this review is to explore these at-risk situations and to suggest adequate anticoagulation therapy, when possible, in each of these complex situations.