How prepared are pharmacists to support atrial fibrillation patients in adhering to newly prescribed oral anticoagulants?

Hamedi, N; Costa, Filipa Alves da; Horne, Robert; Levitan, Michael L.; Begley, Amanda; Antoniou, Sotiris

doi:10.1007/s11096-017-0529-0

Cited by 7 publications

(11 citation statements)

References 18 publications

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“…Concern has been expressed that opportunities for NMS consultations are more limited than originally intended 26 . This is supported by a pharmacist survey that found low levels of NMS provision for patients prescribed oral anti-coagulants for stroke prevention in atrial fibrillation 58 .…”

Section: Conduct Of Consultationsmentioning

confidence: 83%

Community pharmacist led medication reviews in the UK: A scoping review of the medicines use review and the new medicine service literatures

Stewart

Whittlesea

Dhital

et al. 2020

Research in Social and Administrative Pharmacy

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Section: Conduct Of Consultationsmentioning

confidence: 83%

Community pharmacist led medication reviews in the UK: A scoping review of the medicines use review and the new medicine service literatures

Stewart

Whittlesea

Dhital

et al. 2020

Research in Social and Administrative Pharmacy

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“…In the current study, patients on DOACs and those whose medicines were dispensed in MCA were slightly less knowledgeable about their treatment and the need to inform other healthcare professionals before self-medicating to minimise risk of interactions and harm, whereas others have shown no difference in the overall anticoagulant knowledge in VKA and DOAC patients [20]. This may partly be a reflection of pharmacists selfconfidence and knowledge providing care to patients on warfarin compared to DOACs [27,28]. It may also relate to the variation in the types of alert cards and information booklets used despite national initiatives to standardise patient held anticoagulant information.…”

Section: Discussionmentioning

confidence: 56%

Evaluation of patients’ knowledge about oral anticoagulant medicines and use of alert cards by community pharmacists

Jani

Hirani

Livingstone³

2020

Int J Clin Pharm

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Background Anticoagulants continue to pose high risk of harm to patients despite the discovery of novel direct-acting oral anticoagulant agents that require less monitoring than warfarin. Objective To evaluate patients’ knowledge about their oral anticoagulants and the potential role for community pharmacists in optimising safety. Setting Community pharmacies in England. Methods An online survey-based evaluation conducted over a 5-month period to ascertain patients’ knowledge, use of anticoagulant alert cards, compliance with national monitoring requirements for warfarin, and frequency and nature of community pharmacist involvement in optimisation. Differences between patients on direct-acting oral anticoagulant agents and warfarin were assessed using Chi squared tests. Main outcome measure Patients’ knowledge and use of anticoagulant alert cards. Results A total of 1515 pharmacies participated. Of 22,624 patients, 97% knew that they were taking anticoagulants; 20% had alert cards with them at time of dispensing; 17% had no card and 10% refuted their usefulness. Patients on warfarin were more aware of interactions with over-the-counter or herbal medicines than those on direct-acting oral anticoagulant agents. Of the patients on warfarin, 82% confirmed monitoring in the previous 12 weeks in accordance with national standards, with the international normalised ratio value known for 76%. Pharmacists intervened in a fifth of the patients to issue an alert card, contact the general practitioner for a change in the prescription or due to interacting medicines. Conclusion Patients had reasonable knowledge of their anticoagulation therapy, but areas for improvement were identified. Community pharmacists are well placed to optimise the safe use of anticoagulants.

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“…Adverse effects are common in patients taking OACs and, due to knowledge gaps, patients may rely on pharmacists and other healthcare professionals to identify and manage them [7,8]. Pharmacists have reported being less confident in their knowledge of DOACs than VKAs [9]. This might be hypothesised to negatively impact the education provision to patients taking DOACs and potentially lead to a suboptimal detection rate of OAC adverse effects.…”

Section: Introductionmentioning

confidence: 99%

“…Pharmacists are in a key position to provide medication knowledge to patients with AF. Interestingly, pharmacists have been observed to take a different approach when counselling patients on DOACs compared to VKAs [9]. They were less likely to use a checklist to ensure all appropriate points were covered [9], and less confident in their knowledge, skills and access to resources on DOACs [14].…”

Section: Introductionmentioning

confidence: 99%

“…Interestingly, pharmacists have been observed to take a different approach when counselling patients on DOACs compared to VKAs [9]. They were less likely to use a checklist to ensure all appropriate points were covered [9], and less confident in their knowledge, skills and access to resources on DOACs [14]. They reported lacking confidence in their ability to manage bleeding and bruising as potential adverse effects, and reported more confidence in general areas of management such as the indication of the medication [14].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The Quality of Advice Provided by Pharmacists to Patients Taking Direct Oral Anticoagulants: A Mystery Shopper Study

2020

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Pharmacists report being less confident in their knowledge of direct acting oral anticoagulants (DOACs) than of vitamin K antagonists, which may influence their ability to detect and manage complications arising from DOAC use. In a mystery shopper study, patient agents were sent into community pharmacies with symptom or product-related requests related to common complications that might arise during treatment with oral anticoagulants, with each visit being assessed for the preferred outcome. Only 10/41 (24.4%) visits resulted in the preferred outcome. A complete history-taking process, obtaining a medical history, patient characteristics and pharmacist involvement were strong predictors of the preferred outcome being achieved. The preferred outcome was not consistently achieved without pharmacist involvement. The potential for strategies that support comprehensive pharmacist involvement in over-the-counter requests should be considered to ensure the provision of optimal care to patients taking high-risk medications such as DOACs.

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How prepared are pharmacists to support atrial fibrillation patients in adhering to newly prescribed oral anticoagulants?

Cited by 7 publications

References 18 publications

Community pharmacist led medication reviews in the UK: A scoping review of the medicines use review and the new medicine service literatures

Community pharmacist led medication reviews in the UK: A scoping review of the medicines use review and the new medicine service literatures

Evaluation of patients’ knowledge about oral anticoagulant medicines and use of alert cards by community pharmacists

The Quality of Advice Provided by Pharmacists to Patients Taking Direct Oral Anticoagulants: A Mystery Shopper Study

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