Efficacy and safety of a pharmacist-managed inpatient anticoagulation service for warfarin initiation and titration.

Summary What is known and Objective: Anticoagulation consultations provided by a pharmacist-staffed inpatient service, similar to the experience reported in outpatient anticoagulation clinics, can potentially improve anticoagulation control and outcomes. At Tan Tock Seng Hospital, a 1200-bed acute c...

Descripción completa

Detalles Bibliográficos
Publicado en:Journal of Clinical Pharmacy & Therapeutics Vol. 36; no. 5; pp. 585 - 592
Autores principales: Wong, Y. M., Quek, Y.-N., Tay, J. C., Chadachan, V., Lee, H. K.
Formato: research tables/charts Journal Article
Publicado: Wiley-Blackwell Oct2011
Acceso en línea:Ver este registro en EBSCOhost
fields @attributes:
  recordID: 1
pdfLink:
plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=104685565&site=ehost-live
header:
  @attributes:
    shortDbName: ccm
    uiTerm: 104685565
    longDbName: CINAHL Complete
    uiTag: AN
  controlInfo:
    bkinfo:
    dissinfo:
    jinfo:
      jid:
        02694727
        EV4
      jtl: Journal of Clinical Pharmacy & Therapeutics
      issn: 02694727
      maglogo: Y
    pubinfo:
      dt: Oct2011
      vid: 36
      iid: 5
      pid: 480
      pub: Wiley-Blackwell
      place: Malden, Massachusetts
    artinfo:
      ui:
        104685565
        65430243
        10.1111/j.1365-2710.2010.01216.x
        NLM21070296
        104685565
      ppf: 585
      ppct: 7
      formats:
        fmt:
          @attributes:
            type: P
      tig:
        atl: Efficacy and safety of a pharmacist-managed inpatient anticoagulation service for warfarin initiation and titration.
      aug:
        au:
          Wong, Y. M.
          Quek, Y.-N.
          Tay, J. C.
          Chadachan, V.
          Lee, H. K.
        affil: Pharmacy Department
      sug:
        subj:
          Warfarin Administration and Dosage
          Pharmacy Service Methods
          Pharmacy Service Evaluation
          Treatment Outcomes
          Singapore
          Academic Medical Centers
          Inpatients
          Prospective Studies
          Human
          International Normalized Ratio
          Program Implementation
          Fisher's Exact Test
          Mann-Whitney U Test
          Linear Regression
          Sensitivity and Specificity
          Data Analysis Software
          Male
          Female
          Aged
          Middle Age
          Aged, 80 and Over
          Aged: 65+ years
          Middle Aged: 45-64 years
          Aged, 80 & over
          Male
          Female
      ab: Summary What is known and Objective: Anticoagulation consultations provided by a pharmacist-staffed inpatient service, similar to the experience reported in outpatient anticoagulation clinics, can potentially improve anticoagulation control and outcomes. At Tan Tock Seng Hospital, a 1200-bed acute care teaching hospital in Singapore, pharmacist-managed anticoagulation clinics have been in place since 1997. Pharmacist-managed services were extended to inpatient consultations in anticoagulation management from April 2006. Our objective was to assess the effect of implementing a pharmacist-managed inpatient anticoagulation service. Methods: This was a single-centre cohort study. Baseline data from 1 January 2006 to 31 March 2006 were collected and compared with post-implementation data from 1 April 2006 to 31 March 2007. Patients newly started on warfarin for deep vein thrombosis, pulmonary embolism or atrial fibrillation in general medicine and surgery departments were included. The three endpoints were as follows: (i) percentage of international normalized ratios (INRs) achieving therapeutic range within 5 days, (ii) INRs more than 4 during titration and (iii) subtherapeutic INRs on discharge. Results and Discussion: A total of 26 patients in the control period were compared with 144 patients who had received dosing consultations by a pharmacist during the initiation of warfarin. The provision of pharmacist consult resulted in 88% compared to 38% ( P < 0·001) of INR values achieving therapeutic range within 5 days. There was a reduction in INR values of more than 4 during titration from 27% to 2% ( P < 0·001), and subtherapeutic INR values on discharge without low molecular weight heparin from 15% to 0% ( P < 0·001). The mean time to therapeutic INR was reduced from 6·5 to 3·9 days ( P < 0·001) and mean length of stay after initiation of warfarin from 11 to 7·7 days ( P = 0·004). What is new and Conclusion: Inpatient anticoagulation care and outcomes were significantly improved by a pharmacist-managed anticoagulation service. The time to therapeutic INR was achieved appropriately and efficiently without compromising patient's safety.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
    refInfo:
    holdings:
      @attributes:
        islocal: N