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Published on: February 26, 2013

The use of letter communication for patients enrolled in a pharmacist managed anticoagulation clinic

A Geyer1, M A Ford, J P Rindone

  • 1Clinical Pharmacy Section, Southern Arizona VA Health Care System, Tucson, AZ, USA.

Journal of Clinical Pharmacy and Therapeutics
|September 16, 2011
PubMed

Insights

Sending letters for warfarin management is effective. This study found no adverse patient outcomes, demonstrating letters are a viable communication alternative to telephone calls in anticoagulation clinics.

Area of Science:

  • Pharmacology
  • Clinical Pharmacy
  • Patient Communication

Background:

  • Effective communication is crucial for managing patients on warfarin.
  • The optimal method for communicating laboratory results and appointments in busy anticoagulation clinics is not well-established.
  • This study compares letter versus telephone communication for anticoagulation management.

Purpose of the Study:

  • To determine if letter communication is an effective alternative to telephone communication for patients in a pharmacy-managed anticoagulation clinic.
  • To assess the impact of letter communication on patient outcomes, including international normalized ratio (INR) control, missed laboratory draws, and major bleeding events.

Main Methods:

  • A retrospective review of quality assurance data was conducted.
  • Data were analyzed from 4 months before and 4 months after the implementation of letter notifications.
  • Key metrics included percent INR in therapeutic range, missed laboratory draws, and major bleeding events, compared between telephone and letter communication groups.

Main Results:

  • No statistically significant difference was observed in the percentage of INRs within the therapeutic range between the two communication methods.
  • A slight, statistically significant increase in missed INR laboratory draws was noted after the implementation of letter communication (23% vs. 26%).
  • While major bleeding events increased after letter initiation, the difference did not reach statistical significance. Approximately 80% of patients received letters in the letter group.

Conclusions:

  • Letter communication is an effective method for notifying warfarin patients of laboratory results and appointments.
  • This communication strategy does not adversely affect key patient outcomes in an anticoagulation clinic setting.
  • Letters offer a viable alternative to telephone communication for managing anticoagulation therapy.
Abstract

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