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AF anticoagulant omission — GPhC CRA MCQ

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ModerateCardiovascular TherapeuticsAF anticoagulant omissionGPhC CRA

A patient on apixaban 5 mg twice daily for atrial fibrillation says they have missed several doses over the last week and feels palpitations. What is the most appropriate action?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: E — Assess adherence, counsel and signpost for clinical review if symptoms persist

Adherence to direct oral anticoagulants is critical because missed doses rapidly reduce anticoagulant protection. In this vignette, "Assess adherence, counsel and signpost for clinical review if symptoms persist" is the safest single best answer. The other options are less appropriate because they miss the key clinical risk, conflict with UK medicines guidance, or delay needed review.

Reference: BNF; NICE CKS