Counselling patients on oral anticoagulant therapy--a pilot study

On a 38-bed General Medicine Unit, 12 of 15 patients discharged on oral anticoagulant therapy required counselling during a 7-week period. The study indicates that all patients who were responsible for administration of their own drugs after discharge, needed counselling, whether they received anticoagulants prior to admission or not. On average, one hour per week was required to identify the patients, and one hour per patient was spent on counselling. Counselling selected patients provides the pharmacist with a defined role in relation to each patient. It can easily be expanded gradually to include other patients and/or by concomitant monitoring drug therapy.