Comparison of prothrombin time evaluation using automated and bedside devices in cancer patients

Meis, Ernesto de; Mattos, Cláudio Severino; Bettini, E.; Silva, S.P.C.; Castilho, Ilda A.M.

doi:10.1016/j.thromres.2007.10.020

Cited by 1 publication

(1 citation statement)

References 4 publications

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“…The researchers have extensive experience in the use of these monitors in research and practice settings, and their accuracy and ease of use have previously been proven in laboratory-based performance verification studies [39], in the hands of trained healthcare professionals in GP surgeries, community pharmacies and hospital outreach settings [30,40], when used by trained patients undertaking patient self-monitoring [41] and in special groups, such as cancer patients [42]. …”

Section: Methodsmentioning

confidence: 99%

A role for pharmacists in community-based post-discharge warfarin management: protocol for the 'the role of community pharmacy in post hospital management of patients initiated on warfarin' study

Stafford

Peterson

Bereznicki

et al. 2011

BMC Health Serv Res

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BackgroundShorter periods of hospitalisation and increasing warfarin use have placed stress on community-based healthcare services to care for patients taking warfarin after hospital discharge, a high-risk period for these patients. A previous randomised controlled trial demonstrated that a post-discharge service of 4 home visits and point-of-care (POC) International Normalised Ratio (INR) testing by a trained pharmacist improved patients' outcomes. The current study aims to modify this previously trialled service model to implement and then evaluate a sustainable program to enable the smooth transition of patients taking warfarin from the hospital to community setting.Methods/DesignThe service will be trialled in 8 sites across 3 Australian states using a prospective, controlled cohort study design. Patients discharged from hospital taking warfarin will receive 2 or 3 home visits by a trained 'home medicines review (HMR)-accredited' pharmacist in their 8 to 10 days after hospital discharge. Visits will involve a HMR, comprehensive warfarin education, and POC INR monitoring in collaboration with patients' general practitioners (GPs) and community pharmacists. Patient outcomes will be compared to those in a control, or 'usual care', group. The primary outcome measure will be the proportion of patients experiencing a major bleeding event in the 90 days after discharge. Secondary outcome measures will include combined major bleeding and thromboembolic events, death, cessation of warfarin therapy, INR control at 8 days post-discharge and unplanned hospital readmissions from any cause. Stakeholder satisfaction will be assessed using structured postal questionnaire mailed to patients, GPs, community pharmacists and accredited pharmacists at the completion of their study involvement.DiscussionThis study design incorporates several aspects of prior interventions that have been demonstrated to improve warfarin management, including POC INR testing, warfarin education and home visits by trained pharmacists. It faces several potential challenges, including the tight timeframe for patient follow-up in the post-discharge period. Its strengths lie in a strong multidisciplinary team and the utilisation of existing healthcare frameworks. It is hoped that this study will provide the evidence to support the national roll-out of the program as a new Australian professional community pharmacy service.Trial RegistrationAustralian New Zealand Clinical Trials Registry Number 12608000334303.

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