Implementing anticoagulation stewardship: the use of a dedicated mobile phone ‘app’ in the experience of the Italian Federation of Anticoagulation linics (FCSA)

Anticoagulants are life-saving drugs used to prevent and treat thrombosis, and a wide use of these drugs is increasing overtime. However, anticoagulants are one of the most common causes of drug-related adverse events in- and out-of-hospital. The need for empowering clinicians and patients, enhancing compliance and favoring multidisciplinary collaboration, has been widely outlined. Programs of Anticoagulation Stewardship (ACS) have been implemented worldwide. It has been widely demonstrated that ACS is associated with reduction of hospital-acquired blood clots, drug-drug interactions, bleeding events, hospital readmissions, length of hospital stay and other healthcare costs. Although ACS is widely discussed, no ACS model has been extensively and officially realized in the Italian healthcare system. Since its constitution, the Italian Federation of Centers for the Diagnosis of Thrombotic Disorders and the Surveillance of the Antithrombotic Therapies (i.e. FCSA) supported healthcare professionals providing educational programs, aimed to improve anticoagulation quality and to decrease associated risks and costs. In 2021, FCSA developed an app for mobile phones named FCSApp, which was distributed to affiliated physicians. Aim of this study is to describe this experience. FCSApp was actively used for three years by 100 of 232 registered users, with approximately 3200 messages. The channels of main interest were the so-called 'Clinical Cases' with 1671 messages 52.3%), and 'Laboratory' (with 586 messages 18.3%). This experience should be considered in the organization of more comprehensive ACS programs for each national or regional healthcare system.