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Implementing anticoagulation management by pharmacists in the inpatient setting
William E Dager1, Michael P Gulseth
1University of California (UC) Davis Medical Center, Sacramento, CA 95817-2201, USA. william.dager@ucdmc.ucdavis.edu
Summary
Pharmacists can manage inpatient anticoagulation services to reduce adverse events and improve patient care. Key steps include defining roles, securing support, and designing patient-centered programs for successful implementation.
Area of Science:
- Pharmacology
- Health Services Research
- Clinical Pharmacy
Background:
- Anticoagulant therapy is crucial for preventing and treating thromboembolic events.
- Medication-related adverse events are a concern in hospitalized patients on anticoagulants.
- Pharmacist involvement in anticoagulation management can enhance patient safety and outcomes.
Purpose of the Study:
- To identify approaches for implementing pharmacist-involved inpatient anticoagulation programs.
- To describe successful existing inpatient anticoagulation programs.
- To outline steps for developing or expanding such services.
Main Methods:
- Review of two previously reported successful inpatient anticoagulation programs.
- Description of implementation steps and considerations.
- Discussion of challenges and future directions.
Main Results:
- Pharmacist-managed services were successfully implemented at two institutions.
- One program addressed medication-related adverse events through pharmacist selection, education, and coordination.
- The other program expanded from warfarin management to broader anticoagulation services.
Conclusions:
- Successful inpatient anticoagulation programs require clearly defined pharmacist roles.
- Gaining support from healthcare professionals is essential for program establishment.
- Program design must address patient needs and anticipate challenges, including new anticoagulant agents.
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