Who is responsible for the care of patients treated with warfarin therapy?

Warfarin management after discharge from hospital: a qualitative analysis

“…GPs, SSSPs, pharmacists and consumers further emphasized the overall need for greater co-ordination of post-discharge warfarin management processes. Such problems with communication between professionals practicing in different healthcare sectors have also been identified in the literature, 22,25 including potentially dangerous uncertainties regarding who should assume responsibility for warfarin management. 22 GPs have, furthermore, expressed high levels of satisfaction with process changes that have improved provision of warfarin-related discharge information.…”

“…Previous qualitative studies exploring anticoagulation management, although not specifically during the post-discharge period, have identified similar themes. [22][23][24][25][26] Associations have been demonstrated between inadequate warfarin knowledge, poor adherence and adverse outcomes from warfarin therapy; 16,27,28 yet deficiencies in information provision to patients were identified by all participant groups in the current study. These concerns support those expressed in previous studies regarding patients' low levels of warfarin education, high rates of patients reporting never having spoken to their GPs regarding warfarin and GPs having limited opportunities to provide follow-up education.…”

“…These concerns support those expressed in previous studies regarding patients' low levels of warfarin education, high rates of patients reporting never having spoken to their GPs regarding warfarin and GPs having limited opportunities to provide follow-up education. 22,23 Other issues identified have included hospital wards not being conducive to effective communication and patients failing to receive warfarin education owing to workload issues. 24 The need for improved tailoring of information, ongoing reinforcement and alternative modes of education has also been highlighted.…”

Successful Implementation of a Pharmacist Anticoagulant Dosing Service in Ambulatory Care

“…Warfarin's role in the prevention and treatment of thromboembolism and the risks associated with its use are well established. [1][2][3][4][5][6][7] To facilitate warfarin dosing and minimise bleeding risk, regular monitoring of the international normalised ratio (INR) is required, a complex, time consuming and costly activity.…”

“…Anticoagulation with warfarin is often initiated during inpatient stay and maintenance treatment continued and managed in the community. 5,8,9 To facilitate transition from hospital to the community, one model of care is to manage patients in a Hospital-in-the-Home (HITH) program. The patient remains in the program until their warfarin dosing has resulted in a therapeutic INR.…”