Pharmacist-directed heparin therapy using a standard dosing and monitoring protocol

Pharmacy-managed anticoagulation: Assessment of in-hospital efficacy and evaluation of financial impact and community acceptance

“…Pilot studies of pharmacy-managed in-hospital therapy with unfractionated heparin (UFH) [14][15][16][17][18][19] were similar, in both design and outcome, to the warfarin pilot studies discussed previously. For example, several UFH protocol adherence studies used non-homogeneous, historical control groups to assess the primary endpoints of time to reach target activated partial thromboplastin time (APTT) and time within the APTT goal range; pharmacists achieved these endpoints more effectively than standard care (Table 2).…”

Comment: Identifying Optimal Initial Infusion Rates for Unfractionated Heparin in Morbidly Obese Patients

“…This PK approach was independently validated by others. 3 The sample of patients in the initial study 2 for the PK model included those who would fall into Riney et al's 2 lower BMI groups (ie, BMI <25 kg/m 2 and 25-39.9 kg/m 2 ). However, the formula used to estimate heparin distribution volume was derived from a patient sample that apparently also included patients in the group with a BMI of ≥40 kg/m 2 .…”

“…It can be reduced to a pair of calculator-simple equations or a pair of height-weight-heparin rate tables. 3 At this juncture, of course, it would be important to validate the parameters for each major institution to account for interlaboratory differences in aPTT standards and therapeutic ranges, as well as possible differences in heparin requirements for patients with VTE versus those without VTE.…”

Implementing anticoagulation management by pharmacists in the inpatient setting

“…Ambulatory care pharmacist's have performed this function for years, 1 with more recent reports supporting pharmacists' involvement inside of the hospital. [2][3][4][5][6][7][8][9][10][11][12] The purpose of this article is to explore approaches for successful implementation of an inpatient anticoagulation program involving pharmacists. Two successful inpatient anticoagulation programs previously reported in Purpose.…”