Vol. 7, Issue 2, Part H (2025)

Introduction: Anticoagulants are very pivotal drugs used in the prevention and treatment of thromboembolic disorders. However, along with their large use, these drugs are also involved in significant hazards due to their limited medical advantages and large side effects. These drugs can increase morbidity, mortality, and treatment costs in patients when used inappropriately with dosing errors and a lack of monitoring. The anticoagulation stewardship programs (ASPs) intend to deal with these challenges by its coordinated and evidence based practices by health workers.
Aim: This chapter will explore the pharmacology approaches used in the hospital-based anticoagulation stewardship programmes to improve therapeutic safety, reduce complications like bleeding and rational anticoagulants use.
Methods: This study used narrative synthesis methodology that covered the literature from the past 25 years obtained through major search databases such as PubMed, Embase, the Cochrane Library, as well as Google Scholar. The review was specifically aimed at the studies focused on anticoagulation stewardship programs based on hospitals using the agents like warfarin, low-molecular-weight heparin (LMWH), unfractionated heparin (UFH), as well as direct oral anticoagulants (DOACs). 
Conclusion: Anticoagulation stewardship programs in hospitals are an essential part of the reduction of drug side effects. These can be prevented by the promotion of the evidence-based, rational use of anticoagulants. These programs play a major role in the enhancement of patient safety and clinical outcomes through dose optimization, close monitoring, and evidence-based practices. With the evolution of healthcare systems into more connected and value-based systems, the integration of stewardship values into the everyday practice of hospitals becomes not only a best practice but also a practical method of more effective, safer, and patient-centered pharmacotherapy.