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School of Medicine » Department of Medicine » Division of Hematology » Hemostasis & Thrombosis Center
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Anticoagulation Management | Hemostasis & Thrombosis Clinic | Women
Pediatric Hematology Clinic | Inpatient Pharmacist H&T

Anticoagulation Management Service

The Anticoagulation Management Service currently manages over 650 patients on chronic oral anticoagulation therapy. The Anticoagulation Clinic, located in Clinic 2C in Duke South, is open five days a week and is staffed by a Physician Assistant, two Nurse Clinicians, and two Clinical Pharmacists. Medical oversight of the clinic is provided by faculty in the Hemostasis & Thrombosis Center.
 
Most patients are managed by use of a point-of-care capillary blood coagulation meter, but specialized coagulation testing and skill is available for managing outpatients on low molecular weight heparins and patients for whom the INR may not be accurate (e.g., certain patients with the antiphospholipid antibody syndrome). Additional services include developing therapeutic ‘bridges’ for patients on chronic anticoagulant therapy who need a surgical or interventional procedure that will require temporary discontinuation of the anticoagulant.
 
In addition to the outpatient program, there is also a pharmacist-based inpatient service to assist with the management of hemostatic therapies (e.g., recombinant factor VIIa), direct thrombin inhibitors (e.g., lepirudin, argatroban), and with outpatient management of patients with new venous thromboembolic events starting anticoagulant therapy.
 
Current staff for the Anticoagulation Management Service is:
  • Kathy Vokaty, PA-C
  • Karen Powell-Boone, PA-C
  • Karen Baker, RN
  • Dawn Johnson, RN
  • Kimberly Hodulik, Pharm.D
  • Michelle Schoonover, Pharm.D
  • Cinnamon Leggett, LPN
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