New oral anticoagulants in primary care: The general practitioner's point of view

The assessment of new anticoagulants benefits is based on the assessment of thromboembolism and bleeding risks, referring when possible to CHA(2)DS(2)-VASc and HAS-BLED scores. The management of patients treated with new anticoagulants includes a clinical assessment and the annual measure of the creatinine clearance (three times per year in some particular cases). New anticoagulants make hemostasis tests not reliable. The general practitioner has a role in preventing interactions and reporting potential adverse drug reactions. The context of uncertainty about the risk/benefit ratio of new anticoagulants emphasizes the need to integrate the values of the patient in treatment decisions.