Anticoagulants and Anti-platelet Agents in Palliative Home Healthcare.

Sir,

The recent report on anticoagulant (AC) and antiplatelet (AP) agents in the management of hematological malignancies in a home-care program was interesting.[1]

Tendas et al. concluded that ‘AC/AP drugs have been very rarely responsible for significant complications.’[1] The question is whether the present use of AC/AP is clinically favorable. It is not surprising that the use of AC/AP in home healthcare was seen in only 20% of cases in their study. There could be many reasons for this observation. Based on the present report, there appears to be a high incidence of complications or adverse events of AC/AP drugs in clinical practice and, therefore, the use of these drugs in home healthcare for cases with hematological malignancies might be considered a risk. This is no doubt the reason why the use of AC/AP in home healthcare seems to be uncommon in this report. Nevertheless, it cannot be denied that AC/AP drugs are useful in the palliative care management of cases with hematological malignancies. The solution might be the implementation of point-of-care testing (POCT) to closely monitor the effect of AC/AP drugs. There are many easy to use POCT analyzers that can be used at patients’ homes.[2] Using these tools can be helpful in monitoring of pharmacological effect of AC/AP drugs and in early detection of complications. The goal is to use AC/AP drugs for the patient, but without any complications.