The Outcomes of A Pharmaceutical Care Assistance Program in A Romanian Community Pharmacy

Abstract

Objectives: Warfarin has a narrow therapeutic index and is able to cause bleeding. Some efforts to improve knowledge, perseption and patients adherence to conduct warfarin therapeutics through counseling. This research aims to analysis the effects of counseling pharmacist on knowledge, perception, adherence behavior, and INR score recovery on warfarin management. MethOds: Design this research used mixed method, qualitative data used for complete quantitative data. Qualitative used a content analysis with interview . Quantitative method used a quasi experimental method with control groups, pre test, and post test design. Data was collected by prospective method. The sample of this research were taken by consecutive sampling Data collection was conducted by doing interviews and completion of questionnaire before and after counseling. There were 80 respondents, observed for 3 month. Respondents were devided into two groups; treatment group and control group. Data were analysed by wilcoxon test and mann whitney test. Results: Data were collected on 80 patients with Rheumatic Heart Disease (42,5 %), Atrial Fibrilation (17,5 %), Deep Vein Thrombosis (10%), Rheumatic Mitral Valve Disease (10%), Prosthetic Heart (7,5%), other (22,5%). The numbers of patients whose International Normalized Ratio (INR) was in the therapeutic range for each indication were not statistically different between before and after receiving counseling (p> 0.05), Patients' knowledge, perseption, and behavior compliance of warfarin therapy had increased after receiving the counseling service (p< 0.05). cOnclusiOns: Pharmacist counseling can improve knowledge, perception, and adherence behavior, but not improve INR target. The Effect of warfarin to every individual not only affected by behavior compliance, but several factors can influenced effect of warfarin is clinical factors, nonclinical factors, and genetic factors. Clinical factors such as age, gender, pharmacokinethic and pharmacodynamic variability in patiens. Non clinical factors such as dose, interaction drugs, interactions with food, and intake of Vitamin K.