Munson Anticoagulation Clinic

Munson Anticoagulation (Warfarin) Clinic

As warfarin therapy requires close monitoring, Munson Healthcare’s anticoagulation clinic in Traverse City supports patients with minimally invasive testing to ensure their blood is clotting appropriately and provide follow-up care. By offering this clinic, patients can conveniently have their blood monitored close to home. Staffed by specially trained pharmacists, our clinic works closely with primary care providers on medication management. Test results and dosage recommendations are shared with primary care providers, ensuring continuity of care.
 

Services Provided

  • Anticoagulation Management:
    • Fingerstick international normalized ratio (INR) tests are performed on-site in our clinic, removing the need for a venipuncture (unless the INR is critical, i.e., ≥6).
    • Based on patient’s result and answers to specific questions, warfarin dosage is adjusted as needed.
    • Patient’s medication list (including non-prescription products, herbals, and nutritional supplements) are reviewed for duplicate therapies and potential drug interactions. If needed, we will contact the primary care provider’s office for clarification.
    • Patients leave with their INR, dosage instructions, and next appointment schedule.
    • If indicated, we’ll call in a new warfarin prescription to the pharmacy of their choice.
       
  • Perioperative Anticoagulation Management:
    • We’re available to support patients when a procedure/surgery requires warfarin to be stopped beforehand.
    • Using clinical guidance learned from the Bridge Trial,1 we can determine whether the patient needs to be bridged before and after the procedure with Lovenox (enoxaparin). If indicated, we will calculate their ideal dosage, create a patient-specific instruction sheet, and manage their peri-operative anticoagulation, along with ordering the Lovenox and instructing them on how to administer.

Note: Randomized controlled trials indicate that direct oral anticoagulants (DOACs) are not as effective or as safe as warfarin treatment in those who have mechanical heart valves, thrombotic antiphospholipid syndrome, atrial fibrillation associated with rheumatic heart disease, and embolic stroke of undetermined origin. DOAC safety and efficacy has not been proven in large randomized controlled trials for conditions such as left ventricular thrombus, catheter-associated DVT, cerebral venous sinus thrombosis, and for patients with atrial fibrillation or venous thrombosis who have end-stage renal disease.2


Location

Traverse City
Munson Family Practice Center | 1400 Medical Campus Dr., Traverse City
Phone 231-935-9341 | Fax 231-935-9342


How to Refer

A provider referral is required. To refer your patients who are on warfarin, call or fax their information. We will enroll referrals and begin our services promptly.

Although this service is covered by most insurances, patients are encouraged to check with their health insurance provider to understand covered benefits.