Non-Vitamin K Antagonist Oral Anticoagulants: Redefining the Role of the Nurse to Improve Patient Care

Thromboembolic disorders and their associated long-term complications place a burden on patients, healthcare systems and society. Non-vitamin K antagonist (VKA) oral anticoagulants (OACs), including rivaroxaban, dabigatran, apixaban and edoxaban, are effective for the prevention of stroke in patients with non-valvular atrial fibrillation and for the treatment and secondary prevention of venous thromboembolism. The increasing uptake of the non-VKA OACs in primary care lessens the burden of care and allows for an easier transition of treatment from hospital to home. This transformation in terms of patient management has resulted in the need to empower nurses working in this field to endorse management strategies with a focus on patient education and long-term management (i.e. assessment of compliance, scheduling follow-up visits). Management of both venous thromboembolism and stroke prevention in patients with non-valvular atrial fibrillation requires a multidisciplinary team approach and, looking to the future, nurses are likely to have a key role at the heart of the thrombosis team. This review aims to provide nurses with the confidence to manage patients with thromboembolic disorders, and highlights the importance of responsible non-VKA OAC use and the impact that this can have on improving patient care and outcomes.