title: A guide to new anticoagulant medications for ENT surgeons.
abstract: OBJECTIVE
  This study aimed to ascertain otolaryngologists' current knowledge of new (e.g. apixaban, rivaroxaban) and old (e.g. warfarin) anticoagulant medications, and to provide an educational overview of new anticoagulants for use by surgeons.
  
  
  METHODS
  A questionnaire survey was distributed across the Wessex region, UK, to ascertain the levels of knowledge of and confidence in managing patients taking various anticoagulants. In total, 50 questionnaires were completed (41 by trainees and 9 by consultants). A literature review of new anticoagulant medications was then conducted.
  
  
  RESULTS
  In general, there was poor clinical and pharmacokinetic knowledge of newly licensed anticoagulant medications. Respondents were more confident in the use of older vs newer forms of anticoagulants. This was true across all grades of doctors, but particularly at the senior level. All respondents stated that they would like to see an educational resource on anticoagulants.
  
  
  CONCLUSIONS
  Knowledge of newly licensed anticoagulation medications is poor. This study has produced an educational resource for the management of anticoagulant agents. A thorough knowledge of these drugs is essential for the acute management of bleeding patients and in peri-operative surgical planning.
authors.affiliation: Department of ENT Surgery,University Hospital Southampton NHS Foundation Trust,Southampton,UK.
authors.forename: M
authors.initials: M
authors.lastname: Bajalan
authors.affiliation: Department of ENT Surgery,University Hospital Southampton NHS Foundation Trust,Southampton,UK.
authors.forename: T C
authors.initials: TC
authors.lastname: Biggs
authors.affiliation: Department of ENT Surgery,Birmingham City Hospital,Southampton,UK.
authors.forename: S
authors.initials: S
authors.lastname: Jayaram
authors.affiliation: Department of Haematology,Royal Bournemouth & Poole Hospitals,Southampton,UK.
authors.forename: J
authors.initials: J
authors.lastname: Mainwaring
authors.affiliation: Department of ENT Surgery,University Hospital Southampton NHS Foundation Trust,Southampton,UK.
authors.forename: R
authors.initials: R
authors.lastname: Salib
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000925:Anticoagulants / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D002983:Clinical Competence; D003430:Cross-Sectional Studies; D000069604:Dabigatran / Q000009:adverse effects / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced / Q000517:prevention & control*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010036:Otolaryngology / Q000592:standards* / Q000639:trends; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000592:standards* / Q000639:trends; D011720:Pyrazoles / Q000009:adverse effects / Q000627:therapeutic use; D011728:Pyridones / Q000009:adverse effects / Q000627:therapeutic use; D018570:Risk Assessment; D000069552:Rivaroxaban / Q000009:adverse effects / Q000627:therapeutic use; D011795:Surveys and Questionnaires; D006113:United Kingdom
chemical_list: D000925:Anticoagulants; D011720:Pyrazoles; D011728:Pyridones; C522181:apixaban; D000069552:Rivaroxaban; D000069604:Dabigatran
keywords: Anticoagulants; Otolaryngology; Patient Care Management; Pyrazoles