MultiCare Health System

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Anticoagulation Management

Anticoagulation Management Smiling
Anticoagulation is the treatment and prevention of blood clots. These clots can block blood flow to important areas of the body such as the heart, brain, lungs or limbs. An anticoagulant is often prescribed to treat people with blood clots in the legs and lungs, atrial fibrillation or after heart-valve replacement surgery.

The most common anticoagulant prescribed is warfarin, also known as Coumadin®. MultiCare clinics also have experience dosing other anticoagulants such as low molecular weight heparins.

Clinic Introduction

Your physician will need to complete a referral for you to be seen at one of MultiCare's Anticoagulation Clinics. You will be contacted by the clinic staff to schedule an initial appointment.

Services Provided

At each visit, you will see a pharmacist experienced in anticoagulation treatment. The pharmacist will:

  • Measure your INR (International Normalized Ratio). This is done using a point-of-care meter that requires a small amount of blood from your finger. Accurate results are provided within minutes.
  • Assess changes in your health, diet, medications and activities since these can affect warfarin.
  • Make warfarin dose adjustments at the visit, if necessary. Verbal and written instruction of your warfarin dosage is provided.
  • Provide important information related to warfarin including medication and food interactions, side effects and warning signs.
  • Authorize prescription refills for warfarin, if necessary.
  • Address any concerns or questions regarding warfarin therapy.

Your first appointment may last 45 minutes. Comprehensive education is provided during the initial visit. Follow-up appointments take about 15 minutes. The INR will be checked about every four to six weeks, and more often when you first begin therapy.

Benefits of Using MultiCare Anticoagulation Clinics

There are many reasons to choose MultiCare Anticoagulation Clinics:

  • Studies have shown outpatient anticoagulation clinics can provide better anticoagulation control.
  • The clinic is staffed by pharmacists who have extensive experience in anticoagulation therapy.
  • INR is tested with a simple fingerstick and results are available in minutes which eliminates painful blood work, and the longer wait times for lab results.
  • Pharmacists interpret your INR and determine immediately if any dosage changes are needed before you leave the clinic.
  • You will receive individualized patient education and counseling to help meet your needs
  • Family members and/or caregivers can be included in the visits.
  • All documentation is done electronically, which gives MultiCare providers directly involved in your care access to the results.


Contract of Care

We will follow your care closely but you need to take the responsibility to follow exact instructions for drug dosing. It is important to notify the clinic if you have had a recent visit to the Emergency Department, been hospitalized, started a new medication or had any diet changes.

If you are unable to keep your appointment, please notify the office to reschedule. Failure to keep your appointments or to follow any of the instructions given to you could result in serious health risks and/or termination from the program. Please notify the clinic if your telephone number changes.