Anticoagulation Clinic in the VA Pittsburgh Healthcare System

Area of Science:

• Pharmacology
• Healthcare Management
• Clinical Pharmacy

Background:

• The Veterans Administration Healthcare System established an Anticoagulation Clinic (ACC) a decade ago.
• Patient visits to the ACC have surged by 550% over 10 years, indicating high demand.
• Outpatient anticoagulation management has significantly outpaced inpatient services within the VA system.

Purpose of the Study:

• To describe the operational model and outcomes of a VA Anticoagulation Clinic (ACC).
• To evaluate the effectiveness and patient satisfaction with pharmacist-led warfarin management.
• To compare the safety of ACC warfarin management against general medical care.

Main Methods:

• The study details the comprehensive credentialing process for ACC pharmacists.
• Quality improvement monitors were utilized to track warfarin-related complications.
• Patient satisfaction surveys were conducted to assess comfort with pharmacist-led therapy adjustments.

Main Results:

• Warfarin-related complication rates in the ACC are comparable to other specialized clinics.
• Complication rates are lower than those observed in routine medical care settings.
• Patients generally express high satisfaction with pharmacist management of their warfarin therapy.

Conclusions:

• The VA ACC model demonstrates effective and safe management of warfarin therapy.
• Pharmacist-led anticoagulation services are well-accepted by patients and achieve favorable safety profiles.
• The clinic's success highlights the potential for expanding pharmacist roles in chronic disease management.