ADLM releases new guidance on coagulation testing to improve care for patients on blood thinners

WASHINGTON, Nov. 4, 2025 /PRNewswire/ -- The Association for Diagnostics & Laboratory Medicine (ADLM, formerly AACC) has issued expert guidance on coagulation testing in patients taking blood thinners that have the potential to interfere with these tests. By helping clinicians and laboratory medicine professionals to navigate the complex testing scenarios that arise with these patients, the new guidelines will help ensure that they still receive accurate diagnoses and effective treatment.

Read the guidance document here: https://myadlm.org/science-and-research/academy-guidance/coagulation-testing-in-patients-using-direct-oral-anticoagulants

Direct oral anticoagulants (DOACs) are one of the most common types of blood thinners. Patients take them to prevent a host of complications that could arise from blood clotting, including stroke, deep vein thrombosis, and pulmonary embolism. Unlike older anticoagulants, DOACs do not require regular monitoring with coagulation testing, which measures the blood's ability to clot. However, there are still other scenarios in which patients on DOACs might need coagulation testing. This includes when they're experiencing heavy bleeding, being tested for a possible clotting disorder, or before an urgent or elective surgery to ensure bleeding is controlled. In these instances, selecting the right testing approach can be tricky, since DOACs directly interact with the same clotting factors at play in certain coagulation tests.

A group of experts formed by the Academy of Diagnostics & Laboratory Medicine has now created a guidance document on this topic that organizes and simplifies key points from a large body of previously published research and medical reports. Major recommendations from the document include the following:

• When possible, labs and healthcare providers should avoid clot-based testing for patients on DOACs. The guidance details the tests that are and are not susceptible to interference from these drugs so that labs and healthcare professionals can make an informed decision on which tests to use for these patients.
• In scenarios where clot-based testing is necessary, labs and clinicians can mitigate DOACs' potential effects by treating blood samples before testing with agents that neutralize those effects, temporarily discontinuing DOAC treatment before a coagulation test, or temporarily switching a patient to a low-molecular weight heparin.
• In order for any of these strategies to be effective, laboratory medicine professionals and clinicians must communicate effectively, as the perspectives and expertise of both are needed to ensure patients get the appropriate tests and treatments.

"Clinicians ordering coagulation testing for patients taking DOACs should approach these scenarios thoughtfully, as this requires discretion to determine appropriate and optimal timing for testing," wrote the document authors Drs. Lindsay A.L. Bazydlo, Maximo J. Marin, Anna E. Merrill, Louise M. Man, Olajumoke O. Oladipo, and Neil S. Harris. "Communication and collaboration with the laboratory leadership and staff is strongly suggested prior to testing. The laboratory medical director can provide guidance to the clinical team on current methodologies and how to interpret results for patients on DOACs."

About the Association for Diagnostics & Laboratory Medicine (ADLM)
Dedicated to achieving better health for all through laboratory medicine, ADLM (formerly AACC) unites more than 70,000 clinical laboratory professionals, physicians, research scientists, and business leaders from 110 countries around the world. Our community is at the forefront of laboratory medicine's diverse subdisciplines, including clinical chemistry, molecular diagnostics, mass spectrometry, clinical microbiology, and data science, and is comprised of individuals holding the spectrum of lab-related professional degrees, certifications, and credentials. Since 1948, ADLM has championed the advancement of laboratory medicine by fostering scientific collaboration, knowledge sharing, and the development of innovative solutions that enhance health outcomes. For more information, visit www.myadlm.org.

Christine DeLong
ADLM
Director, Editorial and Media Relations
(p) 202.835.8722
[email protected]

Bill Malone
ADLM
Senior Director, Strategic Communications
(p) 202.835.8756
[email protected]

SOURCE Association for Diagnostics & Laboratory Medicine (ADLM)