Anticoagulation in Obese Patients: Applied Clinical Practices in the Non-specialist Setting

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Release Date: February 14, 2024
Expiration Date: February 14, 2025

Expected time to complete this activity as designed:  60 minutes
There are no fees for participating in or receiving credit for this online activity.

Program Overview

This activity explores anticoagulation treatment strategies in special patient groups, including patients with heavy menses, renal issues, or a history of bariatric surgery. This activity is designed to equip its participants with strategies for ensuring optimal anticoagulation in a variety of situations in patients both with and without obesity.

Target Audience

The target audience is the multidisciplinary team of physicians, nurses, and other clinicians specializing in primary care, general practice, family practice and internal medicine who provide health care for obese patients with VTE.

Learning Objectives

Upon completion of this educational activity, participants should be able to:

  • Summarize the role of DVT prophylaxis in obese patients with and without a history of VTE
  • Outline issues of obesity, VTE, and DOAC use in special populations, including considerations for heavy menstrual bleeding, renal issues and bariatric surgery
  • Apply strategies for patient education and engagement that support improved medication adherence and outcomes


Anticoagulation in Obese Patients: Applied Clinical Practices in the Non-specialist Setting

  • DVT prophylaxis for patients on DOACs
  • DOAC use in patients with heavy menstrual bleeding (HMB)
  • DOAC use in patients with poor renal function
  • DOAC use in patients considering weight loss: bariatric surgery versus weight loss medications
  • Patient education and key resources for the primary care clinician

Instructions for Participation and Credit

This activity is eligible for credit through February 14, 2025. After this date, this activity will expire and no further credit will be awarded.

  1. Read the target audience, learning objectives, and faculty disclosures.
  2. You may be asked to complete a short pre-test before accessing the educational content. This must be completed in order to move forward in the activity.
  3. Complete the educational content as designed.
  4. Complete the post-test. To receive a certificate, you must receive a passing score of 70%.
  5. Complete the activity evaluation survey to provide feedback and information useful for future programming.
  6. Certificates for CME, CE, and CNE may be printed immediately after successfully completing the post-test and activity evaluation.

Faculty Biographies

Rachel P. Rosovsky, MD, MPH
Associate Professor of Medicine
Harvard Medical School
Director of Thrombosis Research
Division of Hematology
Massachusetts General Hospital
Boston, Massachusetts

Dr. Rachel Rosovsky earned her medical degree from Harvard Medical School and a master's in public health from Harvard School of Public Health. She completed her residency at Brigham and Women's Hospital, and her fellowship in hematology and medical oncology at the combined Dana-Farber Cancer Institute-Massachusetts General Hospital program. She is Associate Professor of Medicine at Harvard Medical School, and Director of Thrombosis Research, Division of Hematology, and Co-Chair of the Massachusetts General Hospital (MGH) Thrombosis Committee.

Dr. Rosovsky, a board-certified hematologist, provides clinical care full-time, supervises trainees, and conducts research in thrombosis and hemostasis. She is a founder and vice president of the Pulmonary Embolism Response Team (PERT) Consortium, is on the executive committee, and is creator/director of PERT multidisciplinary follow-up clinic at MGH. In addition, she is on the medical/scientific advisory board for the National Blood Clot Alliance (NBCA) and on the executive committee for Venous thromboEmbolism Network US (VENUS). She serves on the committee on Quality for the American Society of Hematology (ASH), and on the thrombosis working group for the International Consortium for Health Outcomes Measurement (ICHOM). She has collaborated worldwide with researchers on risks, diagnosis, and treatment of venous thromboembolism (VTE) and she has published more than 80 scholarly manuscripts in these areas and presented numerous research and clinical presentations at national and international scientific conferences. Since the COVID-19 pandemic, Dr. Rosovsky has been actively involved in investigating how COVID-19 and coagulopathy are affecting patients worldwide. Through lecturing, research, and written works, she has sought to improve care of patients with VTE and advance understanding and treatment of this medical condition for the past 20 years.

Stephan Moll, MD
Department of Medicine
Division of Hematology-Oncology
University of North Carolina
Chapel Hill, North Carolina

Dr. Stephan Moll received his medical degree from Freiburg University, Germany, and performed a pathology residency at the Institute of Pathology, University of Aachen, Germany. He completed an internship/residency in internal medicine and a hematology-oncology fellowship at Duke University Medical Center, North Carolina, and a one-year clinical coagulation fellowship at the University of North Carolina (UNC), Chapel Hill. Dr. Moll has been a faculty member at the University of North Carolina in the Department of Medicine and the Division of Hematology-Oncology since 1999, now at the rank of full professor.

His clinical interest is coagulation and classical hematology, with a particular focus on thrombosis and anticoagulation. Dr Moll’s research interests include clinical trials on new anticoagulants and better use of established anticoagulants. He takes a special interest in clinical-medical education of patients, the public, and healthcare professionals, and is a cofounder of the UNC Blood Clot Education Program Clot Connect. His three main professional goals for the next 5-10 years are 1) enhance the Clot Connect information program, 2) continue to build an “Athletes and Blood Clot Program,” 3) support trainees in their career development in the field of coagulation/hematology.

Bishoy Ragheb, PharmD, BCACP, CDE, CACP, CTTS
Anticoagulation Clinical Pharmacy Practitioner
Veterans Affairs Eastern Colorado Health Care System
Denver, Colorado

Dr. Bishoy Ragheb received his Doctor of Pharmacy degree from Florida A&M University in 2008, and currently serves as an anticoagulation clinical pharmacist practitioner at the Veterans Affairs Eastern Colorado Health Care System in Denver, Colorado. He completed his pharmacy practice residency with a focus on anticoagulation and primary care at the Tallahassee Outpatient Veterans Affairs Clinic and continued to serve veterans there as a clinical pharmacy specialist until 2014.

Between 2014-2023, Dr. Ragheb served as the anticoagulation program manager at the Tennessee Valley Health Systems (TVHS) Veterans Affairs where he initiated and oversaw service operational initiatives including the development of the local anticoagulation stewardship program which led to the improvement of anticoagulation care across Tennessee Valley, resulting in more than a 10% absolute increase in time within therapeutic range as well as the oversight of more than 5500 patients on direct oral anticoagulants. These efforts culminated in TVHS receiving the distinction as an anticoagulation “Center of Excellence”. His site was one of the first VAs to adopt the use of the DOAC population-based management tool and is a pilot site for several improvement initiatives such as the VAs national bleed/clot report population-based management tool.

Dr. Ragheb serves on the VA DOAC population-based management tool SME group and as a resource in assisting other VA facilities with developing their own outpatient stewardship programs. Dr. Ragheb has the privilege of serving on the Anticoagulation Forum’s Centers of Excellence committee and has contributed several resources aimed at improving anticoagulation care.


MediCom Worldwide, Inc. is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

MediCom Worldwide, Inc. designates this enduring material for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
MediCom Worldwide, approved by the California Board of Registered Nursing, Provider Number CEP11380. MediCom designates this CNE activity for 1.0 contact hour. Program Number: 24-017-173


As an organization accredited by the Accreditation Council for Continuing Medical Education (ACCME) and California State Board of Registered Nursing, MediCom Worldwide, Inc. requires everyone who is in a position to control the content of an accredited continuing education activity to disclose all financial relationships with any ineligible company. The ACCME defines “ineligible companies” as any entity whose primary business is producing, marketing, selling, re-selling, or distributing healthcare products by or on patients. A relevant relationship exists if a financial relationship in any amount exists between the person in control of content and an ineligible company; the financial relationship existed during the past 24 months and the content of the education is related to the products of an ineligible company with whom the person has a financial relationship. MediCom will identify mitigation strategies for all persons with relevant financial relationships who control content of the educational activity.

Faculty Disclosures

Dr. Rachel Rosovsky has relevant financial relationships related to advisory and consulting activities from Abbott, Bristol Myers Squibb Company, Dova Pharmaceuticals Inc., INARI Medical, Janssen Pharmaceuticals, Inc., and Penumbra Inc. Dr. Rosovsky is a lead investigator for the Storm PE Trial. She has received research grant(s) from Bristol Myers Squibb and Janssen.

Dr. Stephan Moll has relevant financial relationships related to consulting from Diagnostica Stago, Inc.

Dr. Bishoy Ragheb has no relevant financial relationships to disclose.

All of the relevant financial relationships listed for these individuals have been mitigated.

Unapproved Product Use

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the US Food and Drug Administration. The faculty have been informed of their responsibility to disclose to the audience if they will be discussing off-label or investigational uses of products or devices.

Planning Committee

Joan Meyer, RN, MHA, Executive Director; Sheri Sturgis, Strategy and Education Manager; Lillian McVey, Content Director; and Jennifer Murphy, Project Manager, planners for this educational activity, have no relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, reselling, or distributing healthcare products used by or on patients.

Peer Reviewer

Peer reviewer(s) for this educational activity have no relevant financial relationship(s) to disclose with ineligible companies whose primary business is producing, marketing, selling, reselling, or distributing healthcare products used by or on patients.

If you have any questions or concerns regarding this activity, please contact MediCom Worldwide, Inc. at 1-800-408-4242 or email us at [email protected]

Provided by MediCom Worldwide, Inc.
This activity is supported by an educational grant from Janssen Pharmaceuticals, Inc. administered by Janssen Scientific Affairs, LLC.

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