The Impact of Acute Major Bleeding: Patient Outcomes, Costs, and Practical Considerations

NOTE: If you attended this live CE activity on June 11, 2019 during the 2019 ASHP Summer Meeting & Exhibition AND received CE credit (i.e. a pharmacist CE statement with ACPE Universal Activity Number 0221-0000-19-163-L01-P), you are ineligible to also receive CE credit for this home-study activity.  

Activity Description

With over 33.5 million people worldwide with atrial fibrillation and an estimated 900,000 people in the United States affected by venous thromboembolism (VTE), direct oral anticoagulation (DOAC) use is on the rise. Use of any anticoagulant medication, however, increases the risk of bleeding and may further complicate patient outcomes. Of particular concern are major bleeds occurring in critical sites such as in the case of intracranial hemorrhage (ICH). This activity will evaluate the clinical impact of acute major bleeding and examine safety and efficacy data surrounding the use of oral anticoagulant reversal agents. Faculty will discuss administration streamlining and dosing efficiency techniques, and an interactive question and answer session will provide learners an opportunity to address lingering questions.

Learning Objectives

The target audience for this activity includes clinical and health-system pharmacists, emergency medicine pharmacists, pharmacy directors, chief pharmacy officers, and managed care pharmacists. At the completion of this activity, the participant will be able to:

  • Describe the clinical impact of acute major bleeding for patients on oral anticoagulant therapies.
  • Compare and contrast FDA-approved oral anticoagulant reversal agents.
  • Discuss up-to-date safety and efficacy data surrounding the use of oral anticoagulation reversal.
  • Examine strategies to streamline administration of oral anticoagulant reversal agents and dosing efficiency techniques.


Christian T. Ruff, MD, MPH
Director of General Cardiology
Brigham and Women’s Hospital
Harvard Medical School
TIMI Study Group
Boston, Massachusetts

Jessica M. Rimsans, PharmD, BCPS
Clinical Pharmacy Specialist
Hemostatic and Antithrombotic Stewardship
Brigham and Women’s Hospital
Department of Pharmacy Services
Boston, Massachusetts

CE Accreditation

Release Date: 06-11-2019
Expiration Date: 06-11-2022


ProCE, Inc. is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education. ACPE Universal Activity Number 0221-0000-19-163-H01-P has been assigned to this home study knowledge-based activity (initial release date 6-11-2019). This activity is approved for 1.5 contact hours (0.15 CEU) in states that recognize ACPE providers. The activity is provided at no cost to participants. Participants must complete the online post-test and activity evaluation to receive pharmacy CE credit. No partial credit will be given. Statements of completion will be issued online at, and proof of completion will be posted in NABP CPE Monitor profiles.


It is the policy of ProCE, Inc. to ensure balance, independence, objectivity and scientific rigor in all of its continuing education activities. Faculty must disclose to participants any significant financial interest or affiliation with companies that manufacture or market products discussed during their presentation. Dr. Rimsans has no relevant commercial or financial relationships to disclose. Dr. Ruff has received Research Support from Boehringer Ingelheim, Daiichi Sankyo, MedImmune, and the National Institutes of Health, and is an Advisory Board member and/or Consultant for Bayer, Boehringer Ingelheim, Bristol Myers Squibb, Daiichi Sankyo, Janssen, MedImmune, Pfizer, and Portola. A portion of grant funds received by ProCE from Portola Pharmaceuticals, Inc. will be used to compensate the faculty for this presentation.


This activity is provided by ProCE, Inc. and is supported by an educational grant from Portola Pharmaceuticals, Inc.


The material presented in this CE activity does not reflect the views of ProCE, Inc. or the commercial sponsor. These materials may discuss uses and dosages for therapeutic products, processes, procedures and inferred diagnoses that have not been approved by the United States Food and Drug Administration. A qualified health care professional should be consulted before using any therapeutic product discussed. All readers and continuing education participants should verify all information and data before treating patients or employing any therapies described in this continuing education activity.