Needs assessment analysis for vitamin K antagonist anticoagulation in the resource-constrained setting of Eldoret, Kenya

Pastakia, Sonak D.; Fohl, Alexander L.; Schellhase, Ellen; Manji, I; Ringenberg, Kathryn

doi:10.1331/japha.2010.09226

Cited by 6 publications

(6 citation statements)

References 8 publications

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“…However, despite clear indications for anticoagulation, it is not always implemented in SSA. [26,[36][37][38][39][40][41] Indeed, in the multiregional RELY-AF registry, [4] patients in Africa had the second-lowest use of oral anticoagulation where indicated (19%, second only to China), and the lowest TTR (33%).…”

Section: {Figure 1 Here}mentioning

confidence: 99%

Improving anticoagulation in sub-Saharan Africa -- what are the challenges, and how can we overcome them?

Mouton

Blockman

Wiltshire

et al. 2020

Preprint

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Patients in sub-Saharan Africa generally have poor anticoagulation control. We review the potential reasons for this poor control, as well as the potential solutions. Challenges include the affordability and centralisation of anticoagulation care, problems with access to medicines and INR monitoring, the lack of locally-validated standardized dosing protocols, and low levels of anticoagulation knowledge among health care workers and patients. Increasing numbers of patients will need anticoagulation in the future because of the epidemiological transition in the region. We propose that locally-developed "warfarin care bundles" which address multiple anticoagulation challenges in combination may be the most appropriate solution in this setting currently.

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confidence: 99%

Improving anticoagulation in sub-Saharan Africa -- what are the challenges, and how can we overcome them?

Mouton

Blockman

Wiltshire

et al. 2020

Preprint

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“…A pre‐study needs assessment analysis for anticoagulation, carried out at the Moi Teaching and Referral Hospital (MTRH), Eldoret, Kenya, showed that out of the 554 outpatients assessed, 42.8% [95% confidence interval (CI) (37.96–47.76)] had indications for vitamin K antagonist (VKA) therapy [14]. Of these patients in need of VKA therapy, 53.3% were on aspirin monotherapy and 33.7% were not receiving any pharmacologic therapy.…”

Section: Introductionmentioning

confidence: 99%

Performance outcomes of a pharmacist‐managed anticoagulation clinic in the rural, resource‐constrained setting of Eldoret, Kenya

Manji

Pastakia

et al. 2011

Journal of Thrombosis and Haemostasis

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To cite this article: Manji I, Pastakia SD, Do AN, Ouma MN, Schellhase E, Karwa R, Miller ML, Saina C, Akwanalo C. Performance outcomes of a pharmacist-managed anticoagulation clinic in the rural, resource-constrained setting of Eldoret, Kenya. J Thromb Haemost 2011; 9: 2215-20.Summary. Background: It is recommended that warfarin therapy should be managed through an anticoagulation monitoring service to minimize the risk of bleeding and subsequent thromboembolic events. There are few studies in Sub-Saharan Africa that describe warfarin management in spite of the high incidence of venous thromboembolism (VTE) and rheumatic heart disease. Objective: To examine the feasibility of the Moi Teaching and Referral Hospital anticoagulation monitoring service and compare its performance with clinics in resource-rich settings. Methods: A retrospective chart review compared the percentage time in the therapeutic range (TTR) and rates of bleeding and thromboembolic events to published performance targets using the inference on proportions test. WilcoxonÕs rank sum analyses were used to establish predictors of TTR. Results: For the 178 patients enrolled, the mean TTR was 64.6% whereas the rates of major bleeds and thromboembolic events per year were 1.25% and 5%, respectively. In the primary analysis, no statistically significant differences were found between the results of TTR, major bleeds and thromboembolic events for the clinic and published performance rates. In the secondary analysis, having an artificial heart valve and a duration of follow-up of > 120 days were positively associated with a higher TTR (P < 0.05) whereas venous thromboembolism, history of tuberculosis, HIV and a duration of followup of < 120 days were associated with having a lower TTR (P < 0.05). Conclusions: The performance of the MTRH anticoagulation clinic is non-inferior to published metrics on the performance of clinics in resource-rich settings.

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“…Figure 1 highlights the logic model indicating specific steps taken to establish a sustainable service learning program and the impacts and outcomes on students and community partners. The community partner impacts have been documented within the publications highlighted within this review 19‐28 . The impact of service learning on student pharmacists has been documented in articles they have published in Purdue Journal of Service Learning and International Engagement .…”

Section: Resultsmentioning

confidence: 99%

“…Since PKP began working within the Eldoret community, the PKP has worked with student pharmacists to establish sustainable relationships with five different community partners and completed 23 unique service learning projects (Table 1 19‐31 ). Table 1 highlights the number of unique projects, specific scholarly output and students engaged with each individual community partner.…”

Section: Resultsmentioning

confidence: 99%

Global service learning: A unique educational pathway for community engagement and student scholarship development

Miller

Schellhase

Whicker

et al. 2021

J Am Coll Clin Pharm

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IntroductionService learning is an educational tool that can augment classroom learning with experiential practice. The Purdue Kenya Partnership (PKP) has utilized elective service learning activities to aid student development in research, community engagement, and professional writing.ObjectiveThe purpose of this research is to share PKP's experience in strategically engaging student pharmacists in service learning while completing an 8‐week global health advanced pharmacy practice experience in Eldoret, Kenya.MethodsA retrospective review of PKP's service learning activities conducted between 2004 and 2019 was completed. An outcome‐approach logic model was used to evaluate the program using descriptive statistics to capture the scholarly output and impacts.ResultsPKP has established sustainable relationships with five community partners and completed 23 unique service learning projects lead by 69 individual students. A total of $76 510 was awarded for service learning projects between 2008 and 2019. Students translated their service learning activities into 64 professional posters at regional, national, and international meetings as well as 12 manuscripts between 2004 and 2019.ConclusionPKP has impacted student development through their inclusion of service learning activities. It is used as a pathway for research skill development as evidenced by the student posters, grants, and publications as well as developed long‐standing community partner relationships.

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Needs assessment analysis for vitamin K antagonist anticoagulation in the resource-constrained setting of Eldoret, Kenya

Cited by 6 publications

References 8 publications

Improving anticoagulation in sub-Saharan Africa -- what are the challenges, and how can we overcome them?

Improving anticoagulation in sub-Saharan Africa -- what are the challenges, and how can we overcome them?

Performance outcomes of a pharmacist‐managed anticoagulation clinic in the rural, resource‐constrained setting of Eldoret, Kenya

Global service learning: A unique educational pathway for community engagement and student scholarship development

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