The experience of Hamad General Hospital collaborative anticoagulation clinic in Qatar during the COVID-19 pandemic

Abstract

Hamad General Hospital Anticoagulation Clinic is one of the largest collaborative-practice clinics of its type in Qatar. The patients being followed at this clinic are typically complex and vulnerable. During the coronavirus disease 2019 pandemic, measures were implemented at the clinic to minimize the exposure of patients and healthcare providers to the acute respiratory syndrome coronavirus-2 and to promote social distancing. These measures included extending INR-recall period, transitioning to direct oral anticoagulant drugs whenever feasible, home visits to elderly and immunocompromised patients for INR testing, establishing an anticoagulation hotline, and relocation of warfarin dispensing from the main pharmacy to the anticoagulation clinic. In addition, the clinic shifted its multidisciplinary team meetings onto an online platform using Microsoft Teams. Telehealth consultations were extensively utilized to closely follow up with the patients and ensure that anticoagulation efficacy and safety remained optimal. The aim of this paper is to share our experience and describe the measures adopted by the clinic as part of the Hamad Medical Corporation response to the emerging situation.

Systematic literature review of adopting eHealth in pharmaceutical care during COVID-19 pandemic: recommendations for strengthening pharmacy services

“… 20–62 Among the included studies were 25 observational studies (including 13 cross-sectional studies, 36–39 43–48 54 59 60 5 case series, 34 35 49–51 5 retrospective study, 40 41 52 53 55 1 prospective study 61 and 1 interview study 42 and 18 descriptive studies. 20–33 56–58 62 The general characteristics of the included studies are summarised in online supplemental table 1 . The majority of the studies reported about the use of eHealth by hospital pharmacists, 20 21 23 25 29–31 33–35 37–41 43 46–49 52–55 58 59 61 followed by community pharmacists.…”

“…After removing duplicates (n=795), and screening by the title and abstract (n=230) and full text (n=121), 43 articles were included in this review 20–62. Among the included studies were 25 observational studies (including 13 cross-sectional studies,36–39 43–48 54 59 60 5 case series,34 35 49–51 5 retrospective study,40 41 52 53 55 1 prospective study61 and 1 interview study42 and 18 descriptive studies 20–33 56–58 62. The general characteristics of the included studies are summarised in online supplemental table 1.…”

“…The general characteristics of the included studies are summarised in online supplemental table 1. The majority of the studies reported about the use of eHealth by hospital pharmacists,20 21 23 25 29–31 33–35 37–41 43 46–49 52–55 58 59 61 followed by community pharmacists 28 35 45 46 50 51 54 60 62. Patients with chronic diseases27 31 32 34 37 39 40 43 44 48 52 54 57 60–62 were the primary targets populations of PC-eHealth interventions, followed by patients with COVID-1926 34 42 46 49–51 58 and patients with cancer 27 31 37 40…”

“…Tool(s) involved in the PC-eHealth service models Phone calls alone in the form of a hotline or as a combination with videoconference, social media and television, mobile applications, websites and/or wearable devices were mostly employed to enable PC-eHealth service mode in the included studies. 20 23 25 27 32 35 36 39-43 45 49 50 55-57 [59][60][61][62] Videoconference was often used to allow face-toface interactions and observations of body language and facial expressions between the pharmacists and the patients. 23 25 29 31-35 39 40 42 45-47 50 51 57 59 Social media (eg, Twitter) 24 and Facebook, 34 online networking services (eg, Doximity), 33 41 53 mobile applications (eg, WeChat), 26 38 44 58 Skype, 29 Facetime, 29 PetalMD, 34 Cisco Jabber 12.6, 33 Google voice, 41 53 WhatsApp, 49 61 short messages services, 49 59 Signal 53 and others, 35 46 48 56 and wearable devices 25 had also been integrated into the PC-eHealth service models.…”

Drive‐up INR testing and phone‐based consultations service during COVID‐19 pandemic in a pharmacist‐lead anticoagulation clinic in Qatar: Monitoring, clinical, resource utilization, and patient‐ oriented outcomes

“…8 Some of these strategies were adapted by anticoagulation services in Qatar. 9,10 The practice of phone-based anticoagulation management service (AMS) was described since the 1990s, particularly for homebound and rural populations. 11 Multidisciplinary, phone-based AMS was associated with higher patients' knowledge about warfarin and better satisfaction with care when compared with traditional physician-based practice.…”