PCV7 Implementing and Evaluating Pharmacist-Managed Warfarin Service in Inpatient and Outpatient Setting in Taiwan

Abstract

tively. For hypertensive patients treated with statins (8 included trials) the standardized effect size of DSBP and DDBP was 0.07 (95%CI: -0.07-0.21; pϭ0.33) and -0.12 (95%CI: -0.36-0.11; pϭ0.31), respectively. CONCLUSIONS: Despite previous suggestions, statin therapy in normotensive or hypertensive patients does not lead to reductions in systolic and diastolic blood pressure. Despite these results, however, the routine use of statins, especially in patients with hypertension should be always considered due to the essential reduction of cardiovascular events. OBJECTIVES:The first coronary drug-eluting stent gained its market approval in Europe 2002. Many different drug-eluting stents came to the market worldwide since then. In Taiwan, National Health Insurance has partially reimbursed drugeluting stents since 2006. The number of claimed usage increased from 521 (year 2006) up to 14,311 (year 2010), and total claimed reimburse went up from NTD 15 million to 300 million. The impact to the NHI has been increasing. The aim of this study is to summarize the results of Taiwan drug-eluting stents studies for future researches. METHODS: We systematically searched three bibliographic databases: EMBASE, PubMed and Taiwan National Central Library for studies utilizing Taiwan local data. In order to collect as many local studies as we can, no restrictions were applied on publication year, study type, disease, patients, intervention, comparator and outcomes. RESULTS: Among the 73 studies we identified in EMBASE and PubMed, only one randomized control trial was found. The authors tried to evaluate the preventive outcome of phosphorycholine-coated dexamethasone stent by observing restenosis rate. We then expanded our analysis scopes to controlled trials, and additional 26 studies were identified and 3 studies matched our research question. Their topics were about "1 year follow-up after PCI with Titan versus TAXUS stents", "gender differences in patients undergoing coronary stenting" and "the effects of starting statin therapy before PCI with drug-eluting stents". On the other part of our research at Taiwan National Central Library, there was no paper matched our including criteria. Most of the papers included there were coronary stents design related articles. CONCLUSIONS: Based on systematically research results, we only found one randomized control trial fully used Taiwan local data. Lack of comparative effectiveness on local stents usage could pose a problem when considering evidence-based decision making.