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Published on: February 28, 2012
Interventions unrelated to anticoagulation in a pharmacist-managed anticoagulation clinic
Michael D Hicho1, Amy Rybarczyk2, Melanie Boros2
1Emergency Department, Louis Stokes Cleveland VA Medical Center, Cleveland, OH. michael.hicho@gmail.com.
Purpose:
Results of a study to determine the number of interventions unrelated to anticoagulation made in a pharmacist-managed anticoagulation clinic are presented.
Methods:
A retrospective, single-center cohort was conducted in a hospital-affiliated outpatient pharmacist-managed anticoagulation clinic. Patients were ≥18 years old and attended at least one face-to-face appointment between January 1, 2012, and November 30, 2013. The primary outcome was the number of interventions made outside of an anticoagulation clinic's primary purpose. Interventions were classified based on predetermined criteria. Results of selected interventions were determined along with the association between patient factors and having an intervention. Descriptive statistics and relative risk were used, when appropriate.
Results:
A total of 268 patients were included, and 5846 pharmacist encounters were reviewed. Investigators identified 2222 interventions. Patients having >10 medications were 17% more likely to have an intervention compared with those having <5 medications. Patients attending at least two primary care visits within one year prior to their first appointment with a pharmacist were 12% more likely to have an intervention compared with those attending fewer than two appointments.
Conclusion:
Pharmacists in an anticoagulation clinic made a substantial number of interventions unrelated to anticoagulation therapy, with most clinic patients having at least one such intervention made on their behalf. The majority of these interventions were related to medication reconciliation. The total number of medications being taken and the number of physician visits were significantly associated with an intervention taking place.
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