Original Articles
Vol. 5 No. 2 (2026)
https://doi.org/10.4081/btvb.2026.485

Availability of direct oral anticoagulants testing among Italian anticoagulation clinics: a rapid evolution of clinical practice

On behalf of the Italian Federation of Centers for the Diagnosis of Thrombotic Disorders and the Surveillance of the Antithrombotic Therapies

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Published: 26 June 2026
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Direct oral anticoagulants, laboratory test, anticoagulation management

Authors

Daniela Poli
daniela.poli.mail@gmail.com
Thrombosis Centre, Careggi University Hospital, Florence, Italy.
Antonio Ciampa
Hemostasis Center, AORN S.G. Moscati, Avellino, Italy.
Valeria De Micheli
Hemostasis and Thrombosis Unit, Lecco Hospital, Lecco, Italy.
Angela Maria Iannone
Transfusion Medicine Unit, Molfetta Hospital, Molfetta (BA), Italy.
Giuseppe Malcangi
Hemophilia and Thrombosis Center, Policlinico University Hospital, Bari, Italy.
Giuseppe Rescigno
Clinical Pathology Unit, University Hospital San Giovanni di Dio e Ruggi d’Aragona, Salerno, Italy.
Cinzia Scarone
Thrombosis Center, S. Paolo Hospital, Savona, Italy.
Sophie Testa
Hemostasis and Thrombosis Center, Cremona Local Health Unit, Italy.
Marco Marietta
Haemostasis and Thrombosis Unit, Department of Haematology and Oncology, University Hospital of Modena, Italy.

Background: Direct oral anticoagulants (DOACs) are largely prescribed, and the lack of need for a laboratory monitoring was the main reason for their large diffusion. However, a wide inter-individual variability has been described, and the need for blood levels measurement when a thrombotic or hemorrhagic event occurred has been suggested.

Materials and methods: In 2022, a survey was conducted among the Italian centers affiliated with the Italian Federation of Centers for the Diagnosis of Thrombotic Disorders and the Surveillance of the Antithrombotic Therapies - FCSA, recording that only few centers provided DOACs testing. In 2025, a second survey was performed to evaluate if a change in that area have occurred.

Results: We observed a rapid increase in the number of centers providing DOAC testing, from 39/124 (31.0%) in 2022 to 72/122 (59.0%) in 2025; 26% of centers not providing DOAC testing, claimed no funding for testing. In 70/72 (97.2%) of centers, DOAC testing was limited to selected conditions, such as thrombotic or hemorrhagic complications.

Conclusions: Data derived from our survey are relevant in developing adequate anticoagulation stewardship programs, that are increasingly required.

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Ethics Approval

Not required

CRediT authorship contribution

Conception and design: D.P., A.C., V.DM., A.I., G.M., G.R., C.S. Analysis and interpretation of the data: D.P., S.T., M.M. Drafting of the article: D.P. Critical revision of the article for important intellectual content. Final approval of the article: all the authors.

Supporting Agencies

Italian Federation of Centers for the Diagnosis of Thrombotic Disorders and the Surveillance of the Antithrombotic Therapies.

Data Availability Statement

The datasets used and/or analyzed during the current study are available upon reasonable request from the corresponding author.

How to Cite



1.
Poli D, Ciampa A, De Micheli V, Iannone AM, Malcangi G, Rescigno G, et al. Availability of direct oral anticoagulants testing among Italian anticoagulation clinics: a rapid evolution of clinical practice: On behalf of the Italian Federation of Centers for the Diagnosis of Thrombotic Disorders and the Surveillance of the Antithrombotic Therapies . Bleeding Thromb Vasc Biol [Internet]. 2026 Jun. 26 [cited 2026 Oct. 9];5(2). Available from: https://www.btvb.org/btvb/article/view/485
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