Strengths and limitations:
To the best of our knowledge this is the first study that evaluates the effect of antithrombotic stewardship in which a prospective daily monitoring of all hospitalized patients on combined antithrombotic therapy is part of daily clinical practice. Therefore, the results of this study reflect the daily clinical practice. Additionally, agreements were made in advance within the ASP with regard to guidelines, responsibilities, tasks and communication and therefore we had a good basis that resulted in a dedicated and committed ASP team. Other strengths are the prospective study design and the follow up after post-discharge to evaluate medication safety. However, the present study should be viewed in the context of several limitations. Firstly, not all the interventions were recorded by the members of the antithrombotic stewardship. This implicated that the real number of interventions is in fact higher than reported. Secondly, for the safety outcomes we only relied on data in the medical record in our hospital, which can result in an underestimation of complications. Thirdly, due to COVID-19 pandemic we had fewer admissions in the last month of the study. Lastly, the external validity is limited due to the single-centre study design. Despite these limitations, with our results, we showed that implementing a multidisciplinary ASP is effective in improving antithrombotic care in patients with combined therapy.