Why the study?
Measurement and interpretation of DOAC anticoagulant effect face challenges including lack of therapeutic ranges, assay inaccuracies, undefined clinical thresholds, and uncertainty regarding application to care.
Assessment of plasma DOAC concentration may be helpful in select emergency and non-emergency clinical scenarios, despite routine monitoring not being required.
Introduction There are important challenges with the measurement and interpretation of direct oral anticoagulant (DOAC) anticoagulant effect including a lack of therapeutic ranges, inaccuracy of routinely available coagulation assays, lack of established thresholds for clinically significant effect, and uncertainty about how to apply the results to patient care. Objective In this narrative review, we provide a practical approach to DOAC measurement in clinical practice. Methods By summarizing the literature and using illustrative cases, we highlight key principles of commonly available tests, outline potential indications for measuring DOAC drug levels, and provide guidance on interpreting results to inform management decisions. Conclusion While DOACs do not require routine monitoring of anticoagulant effect, assessment of plasma DOAC concentration may be helpful in select emergency and non‐emergency clinical scenarios.
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Mithoowani et al. (2025) conducted a review in Direct oral anticoagulant (DOAC) measurement. DOAC measurement was evaluated.
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