1. What is ManageAnticoag?
  1. What is ManageAnticoag?

ManageAnticoag helps clinicians navigate periprocedural planning and bleed management scenarios for patients on oral anticoagulants (OAC). The app is comprised of three tools to support the following clinical decisions:

  • Assessing whether and how to interrupt and bridge anticoagulation
  • Managing acute bleeds, including the suggested use of reversal agents
  • Determining whether and how anticoagulation should be restarted

Users of the app should select which tool best applies to the patient scenario and follow these steps:

  • Enter patient details as prompted in the selected tool
  • View individualized guidance on the advice screen
  • Email a summary of the advice

Users can also access the Quick Reference section for supporting information and details such as "Guidance for Administering Reversal Agents" and "Components of the Clinician-Patient Discussion."

ManageAnticoag also serves as an update to ACC's previous BridgeAnticoag app, released in February 2017. ManageAnticoag retains, updates, and adds to the content of the previous app. Users who already have BridgeAnticoag on their phone or table will be updated to ManageAnticoag automatically.

  2. Who is the intended audience for ManageAnticoag?
  2. Who is the intended audience for ManageAnticoag?

The intended audience of the app are clinicians involved in the management of patients who are taking oral anticoagulants. It is designed to be used by clinicians both within and outside of cardiology. This may include general cardiologists, interventional cardiologists, proceduralists of any specialty, hospitalists, primary care physicians, physician assistants, nurse practitioners, and medical students.

  3. How can I access ManageAnticoag?
  3. How can I access ManageAnticoag?

The ManageAnticoag app is free for both ACC members and non-members and can be downloaded on mobile apps or used on the web.

  4. How is ManageAnticoag intended to be used as part of clinical care?
  4. How is ManageAnticoag intended to be used as part of clinical care?

ManageAnticoag is intended to support clinical decision making related to the management of patients who are currently taking oral anticoagulants. The app provides guidance on periprocedural interruption and bridging, management of acute bleeds, and determining anticoagulation reinitiation. The information and recommendations in the app are intended as a decision aid and are not intended to represent the only or best course of care, or to replace clinical judgment for diagnosis, cure, mitigation, treatment, or prevention of disease. Use of the app assumes clinicians will conduct a full evaluation of the patient, consult relevant medical specialists as needed, and utilize a team-based approach to optimize therapy. In addition, it is recommended that therapeutic options should be determined after discussion between the patient and their care provider.

  5. Will patients benefit from use of the ManageAnticoag app?
  5. Will patients benefit from use of the ManageAnticoag app?

The app is intended for use by clinicians as part of clinical practice. The app is freely available to all users, including patients, but is not intended for direct use by patients. It may benefit patients as a tool used by clinicians for shared decision making.

  6. Where did the information and recommendations in ManageAnticoag come from?
  7. How was ManageAnticoag developed and tested?
  7. How was ManageAnticoag developed and tested?

The design and development of the app were managed by ACC with the review and guidance of a work group of ACC members who also served on the writing committee for the source documents for the app. Development of the app also included user testing with members of the ACC, as well as outside clinicians from relevant specialties.

  8. Are there plans to further update ManageAnticoag?
  8. Are there plans to further update ManageAnticoag?

ManageAnticoag is an update and rebranding of the previous BridgeAnticoag app, based on the recently released 2017 ACC Expert Consensus Decision Pathway on Management of Bleeding in Patients on Oral Anticoagulants. Content in the app will continue to be updated to reflect any changes to its source documents and the related clinical environment. Relevant relationships to other existing ACC clinical policy documents and resources will also be considered in future updates. Lastly, ongoing user feedback helps identify needs and opportunities for future updates.

  9. How can I provide feedback on ManageAnticoag and how will it be used?
  9. How can I provide feedback on ManageAnticoag and how will it be used?

You can provide feedback and suggestions about the app in two ways:

  1. Complete the ACC's feedback survey here, or through the "About App" section in the app.
  2. Leave comments on the iTunes or Google Play page for the app.

The ACC is also collecting data about the app through analytics, usability studies, and impact studies when possible. Feedback is used to ensure the app's accuracy and to identify opportunities for improving the app's user experience and to inform the ACC Mobile App portfolio.

  10. Will any personal or patient information be collected from ManageAnticoag?
  10. Will any personal or patient information be collected from ManageAnticoag?

No patient information is collected and stored in the app. Anonymous user behavior (e.g., number of people who downloaded the app, how many times a day the app was used) will be gathered through Google Analytics. All data collected in the app is anonymous and cannot be traced back to an individual user.

  11. How does ManageAnticoag relate to other ACC tools, products, and programs?
  11. How does ManageAnticoag relate to other ACC tools, products, and programs?

The app is intended to be used in concert with ACC's other anticoagulation clinical policies and tools for the comprehensive management of an anticoagulated patient. These resources include the ACC Anticoagulation Initiative, the AnticoagEvaluator app, and patient-focused anticoagulation resources on CardioSmart.org. The app is part of the ACC Clinical Mobile App Collection designed to be used as a point-of-care tool to help optimize patient care. More information about ACC's Clinical App Collection can be found here.

  12. What is the relationship of ManageAnticoag to other societies and organizations?
  12. What is the relationship of ManageAnticoag to other societies and organizations?

ManageAnticoag was developed solely by the American College of Cardiology. Financial support for the app was provided by Boehringer Ingelheim, Daiichi Sankyo, Inc. and Janssen Pharmaceuticals, Inc. All content and design were independently developed with no sponsor involvement.

  13. How does ManageAnticoag relate to other anticoagulation tools in the market?
  13. How does ManageAnticoag relate to other anticoagulation tools in the market?

The CDC and Georgia Tech recently released an app called the CDC Anticoagulation Manager which is a free mobile application (only for IOS devices). It is similar to ManageAnticoag in that it addresses topics related to the management of patients on anticoagulants. It is intended for clinician use and provides guidance on anticoagulant dosage based on whether the clinician is starting, switching, or reversing an anticoagulant. The ACC ManageAnticoag app is distinct because it focuses on the management of clinical scenarios related to the use of anticoagulants and allows the user to input patient characteristics to receive individualized advice. It also reflects information on the newly FDA approved drug, andexanet alfa. ManageAnticoag also has a Quick Reference section that lends itself to be a more comprehensive educational tool. It is available for iOS devices, Android users, and in web format. There are also other mobile apps related to anticoagulation which include WarfarinGuide, Fix INR, MAQI2 and iWarfarin which all specifically address the use of warfarin, and do not include information about other anticoagulants.

  14. Are there any plans to link outputs from ManageAnticoag to electronic medical records (EMRs)?
  14. Are there any plans to link outputs from ManageAnticoag to electronic medical records (EMRs)?

The app has an email function for users to send a summary of their individual app sessions to a recipient of their choice. These outputs can then be transferred into EMR notes. Users can also utilize a query string functionality to export data points from their EMR to populate the app's questions. However, there is no current functionality to export results and output from the app back to the EMR.

  15. Where can I get help and support with using ManageAnticoag?