Why the study?
Although plasma direct oral anticoagulant (DOAC) levels are not routinely required for most patients, they can provide valuable information in urgent clinical situations and select non-urgent indications.
DOAC level testing is not routinely needed but can guide clinical decision-making in urgent situations like severe bleeding or perioperative management, as well as in specific non-urgent scenarios.
Supports selective testing in emergencies without routine use; leaves open need for prospective outcome studies.
Plasma direct oral anticoagulant (DOAC) levels are not routinely required for the majority of patients; however, they may provide valuable information in urgent clinical situations, including perioperative management, life‐ or limb‐threatening bleeding and patients requiring thrombolysis, when measurement mostly aims to determine whether a clinically significant concentration of DOAC is present in plasma. In non‐urgent indications, including investigation of DOAC failure and in patients with extremes of body weight or drug–drug interactions, levels may assist clinical decision‐making by determining whether the plasma DOAC level is within expected therapeutic ranges. ‘In a nut‐shell’ review, we summarise the current recommendations and limitations regarding testing DOAC levels.
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Swan et al. (2026) studied this question.
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