Clinical pharmacy anticoagulation services in a group model health maintenance organization

The clinical pharmacy anticoagulation service (CPAS) at a large group model health maintenance organization is described. The service has expanded dramatically from a local service providing anticoagulation monitoring for the patients of a single physician to a regional service staffed by seven full-time employees who monitor over 3,000 patients. The structure and operations of the CPAS are described as well as the processes used to manage anticoagulation therapy complications. A program for treating patients with deep vein thrombosis in the outpatient setting using enoxaparin is also described.