For patients receiving anticoagulation therapy for treatment of VTE, the ASH guideline panel suggests against using visual medication schedules (provided to patients at each visit, along with brief counseling) to improve medication adherence (con- ditional recommendation based on very low certainty in the evidence about effects ). Summary of the evidence. One RCT reported the effect of a visual medication schedule provided to patients at each visit, along with brief counseling.164 The main outcome was the time elapsed before achieving target anticoagulant control. Secondary outcomes included TTR during the 90-day study period, mortal- ity, and hospitalizations. The EtD framework is shown online at 1ECEC061E826. Benefits. For benefits, see the evidence profile in the EtD framework referenced at the end of the previous section, available online. Compared with controls, a visual medication schedule modestly increased TTR, but the CI included no effect (MD, 2.6% higher [95% CI, 7.6% lower to 12.9% higher]; very low certainty). There was no effect of a visual medication schedule on PE/DVT because these outcomes did not occur in any study patient. Harms and burden. The estimate of the intervention on mortality was unreliable as only 1 death occurred in the study (ARR, 14 more per 1000; very low certainty). Hospitalization was increased in those using the visual medication schedule (RR, 1000 [95% CI, 3 more to 568 more per 1000]; very low certainty). 27 NOVEMBER 2018 x VOLUME 2, NUMBER 22 ASH 2018 VTE GUIDELINES: ANTICOAGULATION MANAGEMENT 3275 Other EtD criteria and considerations. The intervention was feasible to implement, as it is currently being used in some settings. Although costs have not been formally assessed, they are likely moderate. Conclusions and research needs for this recommendation. 