Reduction in Warfarin Adverse Events Requiring Patient Hospitalization After Implementation of a Pharmacist-Managed Anticoagulation Service

Abstract

At 6 months after discontinuation of the pharmacist-managed anticoagulation service, the frequency of adverse events increased significantly, resulting in both an increased number of hospitalizations and an increased number of hospital days accrued. This coordinated anticoagulation program using a pharmacist reduced warfarin-related complications.

Patients’ and physicians’ satisfaction with a pharmacist managed anticoagulation program in a family medicine clinic

“…Evidence indicates that a coordinated pharmacist managed anticoagulation program is associated with less adverse events and hospitalization admissions as compared to usual care [3, 4]. A recent meta-analysis indictated that pharmacist-participated warfarin management therapy significantly reduced total bleeding, with a non-significant trend towards decreases in other warfarin-related complications [5].…”

Assessment of patient perceptions concerning a community pharmacy-based warfarin monitoring service

“…Recently, there has been an increasing movement toward more clinical involvement within the healthcare team and pharmacists have been effectively managing anticoagulation services for many years. 2,3,4,5,6 . Positive benefits seen with pharmacist-directed management include:…”

“…Corresponding author: Jennifer Waitzman, UNC Eshelman School of Pharmacy, University of North Carolina at Chapel Hill, Beard Hall, Campus Box 7574, Chapel Hill, NC 27599, 919-843-3861, jennifer_waitzman@unc.edu maintaining goal INR range, decreased warfarin-related hospital admissions, decreased length of stay, decreased number of major thromboembolic events, increased patient education, and improved compliance 2,6 . The usual settings in which pharmacists manage anticoagulation services include community hospitals, ambulatory care clinics, and physician offices 3 …”

Delivery of Optimized Anticoagulant Therapy: Consensus Statement from the Anticoagulation Forum

“…15, 16 The benefits of AMS are well documented. 16,17 However, the majority of anticoagulated patients in North America do not receive care from such services. Thus, recommendations for delivering optimized anticoagulation therapy (OAT) should apply to all clinicians involved in the care of outpatients receiving anticoagulation, regardless of the structure and setting in which that care is delivered.…”