Table 1 Characteristics of OAT provided by Dutch ACs [8, 12, 28]

History

The first AC was introduced in 1949.

Number

61 ACs manage OAT for all outpatients in the Netherlands.

Organization

Substantial organizational variations exist between ACs such as the location (within or outside the hospital), the legal form (independent organization or department of hospital or GP-lab), and the number of patients (about 1100 to 21500 patients).

Chronic care management

The International Normalized Ratio (INR) - a standardized transformation of the prothrombin time - is used to determine the dosage of oral anticoagulants needed to correct the prothrombin time.

The management of OAT by specialized nurse and/or physicians of all ACs implies: measuring INRs, gathering relevant patient information, providing patient education and self-management support, and giving dosage advices.

Patients on oral anticoagulants consult an AC at least once every 6 weeks.

Additional tasks

ACs can perform additional tasks such as giving dosage advices before surgery, giving dosage advices for patients living in nursing homes, and giving dosage advices to hospitalized patients.

Collaboration

Collaboration varies between ACs. For instance, about 55% percent of ACs have formal agreements with at least one hospital, 19% use a webbased clinical information system, and less than half of all ACs are always informed about interacting drugs by the pharmacist.