Impact of a Multidisciplinary Anticoagulation Stewardship Program in a Tertiary Care Hospital in Riyadh: A Retrospective Study

Background: Anticoagulation therapy is linked to serious risks, especially in inpatient care. Anticoagulation stewardship programs (ASPs) are designed to improve safety and effectiveness through teamwork between healthcare professionals.Objective: This study assessed the effect of a multidisciplinary ASP—run by nurses, pharmacists, and hematologists—on patient outcomes, medication safety, and team practice in a tertiary hospital in Riyadh.Methods: A retrospective observational study was carried out from January to April 2024 with 200 inpatients receiving anticoagulants. Patients who received ASP interventions (n=120) were compared with a control group (n=80). Data were collected on bleeding, thromboembolic events, INR levels, and hospital stay. The number of interventions and their acceptance by physicians were also recorded. Staff interviews were conducted to explore teamwork experiences.Results: The ASP group had lower rates of major bleeding (2.5% vs 8.8%) and thromboembolic events (0.8% vs 5%), as well as fewer supratherapeutic INR episodes. Their average hospital stay was 1.5 days shorter, and 78% reached therapeutic INR at discharge compared with 61% of the control group. A total of 230 interventions were reported, with a 92% acceptance rate. Interviews showed better communication and stronger team responsibility.Conclusion: The ASP improved patient safety, clinical outcomes, and professional collaboration. These results support the use of ASPs in hospitals, especially in the Gulf region.