Furthermore, AMS is most likely to be beneficial when implemented in a population with inadequate TTR managed by nonspecialized providers. Decision-makers should consider the upfront costs of setting up the AMS as well as costs to maintain the service. The panel also noted that AMS can provide specialized consulting and education for health care providers in the region, thereby potentially enhancing anticoagulation management beyond the service s direct patient management. AMS providers should keep track of the service s TTR as well as anticoagulation-related clinical outcomes for their patients. Health care providers referring patients to an AMS should keep track of whether they attended the AMS. With regard to research priorities, the panel determined that RCT evidence needs to be strengthened to be considered superior to the reported observational evidence. Cluster RCTs are needed that are appropriately randomized, enroll patients before unblinding of allocation, are sufficiently powered to detect a difference in clinical outcomes using blinded outcome assessment (including the follow- up time after dropping out of AMS care), use a consistent definition or elements of AMS, and address the impact of AMS for patients receiving DOAC therapy. Structured patient education Question: For patients receiving oral anticoagulation therapy for VTE treatment, should supplementary patient education be offered vs no supplementary patient education? For patients receiving oral anticoagulation therapy for VTE treatment, the ASH guideline panel suggests using supple- mentary patient education in addition to basic education for patients receiving oral anticoagulation for VTE treatment (conditional recommendation based on very low certainty in the evidence about effects ). Summary of the evidence. This question specifically evaluated whether educational interventions over and above what most patients receive from health care providers (eg, the prescriber and/or dispensing pharmacist) in the usual course of anticoagulant prescribing improves anticoagulation therapy outcomes. 