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Related Experiment Videos

Nine-year experience with a pharmacist-managed anticoagulation clinic.

R R Conte, W A Kehoe, N Nielson

    American Journal of Hospital Pharmacy
    |October 1, 1986
    PubMed
    Summary

    Pharmacist-managed anticoagulation clinics effectively control warfarin dosage, maintaining therapeutic prothrombin times with acceptable patient outcomes and low rates of bleeding and thromboembolic events.

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    Area of Science:

    • Clinical Pharmacy
    • Pharmacotherapy
    • Cardiovascular Medicine

    Background:

    • Anticoagulation therapy, particularly with warfarin, requires careful management to balance efficacy and safety.
    • Pharmacist-led clinics offer a potential model for optimizing anticoagulation control.

    Purpose of the Study:

    • To evaluate the outcomes of a pharmacist-managed anticoagulation clinic over a nine-year period.
    • To assess the effectiveness of pharmacist-led warfarin dosage adjustments in maintaining therapeutic anticoagulation.

    Main Methods:

    • A pharmacist managed an anticoagulation clinic for ambulatory and inpatient cases.
    • Warfarin dosage was adjusted to maintain prothrombin times within the therapeutic range (1.7-2.5 times normal).
    • Patient outcomes, including prothrombin time control, hemorrhagic events, and thromboembolic events, were monitored.

    Main Results:

    • During the study period (1975-1984), 59.2% of prothrombin times fell within the therapeutic range.
    • Low rates of major (0.002/patient-treatment month) and minor (0.05/patient-treatment month) hemorrhagic events were observed.
    • The recurrence rate of thromboembolic events was 0.007 per patient-treatment month.

    Conclusions:

    • Pharmacist-managed anticoagulation clinics can achieve acceptable levels of anticoagulation control.
    • This model of care resulted in a morbidity profile comparable to physician management.
    • Pharmacist involvement in anticoagulation management is effective and safe.

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