Related Experiment Video

Updated: Sep 13, 2025

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
23:33

The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation

Published on: February 28, 2012

83.9K

Blister packaging to support warfarin adherence in paediatric patients: A pilot retrospective study

Leanne T Meakins1,2, Joel R Livingston1,2, Mary E Bauman1,2

  • 1KidClot Program, Stollery Children's Hospital, Edmonton, Alberta, Canada.

Paediatrics & Child Health
|August 4, 2025
PubMed

Insights

Blister packaging (BP) may improve warfarin adherence in children. This study found BP reduced missed doses and reminders, with a trend toward increased time in therapeutic range (TTR).

Area of Science:

  • Pediatric pharmacology
  • Medication adherence research
  • Clinical pharmacy practice

Background:

  • Warfarin is prescribed for specific pediatric indications, but adherence is challenging.
  • Nonadherence to warfarin in children can lead to serious complications.
  • Blister packaging (BP) is not standard for warfarin due to dose adjustments but may enhance adherence.

Purpose of the Study:

  • To assess the effectiveness of blister packaging (BP) for warfarin management in pediatric outpatients.
  • To evaluate the impact of BP on medication adherence and clinical outcomes.

Main Methods:

  • A retrospective chart review was conducted on children (18 months to 18 years) with poor warfarin adherence switched to BP.
  • Data included international normalized ratio (INR) reminders, missed doses, and adverse events for 6 months pre- and post-BP.
  • Time in therapeutic range (TTR) was analyzed as a measure of safety and efficacy.

Main Results:

  • Eleven pediatric patients were included in the review.
  • BP use was associated with a 30% decrease in INR reminders and a 20% decrease in missed warfarin doses.
  • Median TTR increased by 11.61% post-BP, though this was not statistically significant (P=0.1602).

Conclusions:

  • Blister packaging (BP) is a viable tool for supporting warfarin management in children.
  • Caregivers reported BP as beneficial, noting a trend toward improved TTR and reduced healthcare provider workload.
Abstract

Keywords:
Blister packagingMedication adherenceWarfarin

More Related Videos

A Clinical Trial Assessing the Safety, Efficacy, and Delivery of Olive-Oil-Based Three-Chamber Bags for Parenteral Nutrition04:53

A Clinical Trial Assessing the Safety, Efficacy, and Delivery of Olive-Oil-Based Three-Chamber Bags for Parenteral Nutrition

Published on: September 20, 2019

10.8K
Evaluation of Drug Sorption to PVC- and Non-PVC-based Tubes in Administration Sets Using a Pump06:08

Evaluation of Drug Sorption to PVC- and Non-PVC-based Tubes in Administration Sets Using a Pump

Published on: March 11, 2017

10.7K

Related Concept Videos

Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants01:18

Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants

Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
1.3K
Venous Thrombosis III: Interprofessional Care01:29

Venous Thrombosis III: Interprofessional Care

Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
22
Blinding01:11

Blinding

Blinding is a commonly used method of not telling participants which treatment a subject is receiving. Blinding is a critical part of a randomized control trial or RCT. It reduces the bias that affects the results. In an RCT, blinding is used in the form of a placebo. A placebo effect occurs when untreated subjects falsely believe they have received the treatment and report improved symptoms. A placebo or a dummy treatment is administered to subjects to negate the bias caused by such an effect.
2.6K
Drug Delivery: Parenteral Route01:29

Drug Delivery: Parenteral Route

The parenteral route is a critical method of drug administration. It delivers compounds directly into the systemic circulation and bypasses the gastrointestinal tract. This approach is particularly advantageous for drugs that exhibit poor absorption or instability when administered orally.
There are three primary parenteral routes: intravenous (IV), intramuscular (IM), and subcutaneous (SC). The IV route introduces the drug directly into the bloodstream, ensuring immediate action. The IM route...
834
One-Compartment Open Model for IV Bolus Administration: General Considerations01:19

One-Compartment Open Model for IV Bolus Administration: General Considerations

The one-compartment model is a pharmacokinetic tool that models the body as a single, uniform compartment, facilitating the understanding of drug distribution and elimination. This model is particularly beneficial for intravenous (IV) bolus administration, where the drug rapidly circulates throughout the body.
The drug's presence in the body is defined by an equation representing the difference between the rates of drug entry and exit. Key parameters—elimination rate constant,...
318
One-Compartment Open Model for IV Bolus Administration: Estimation of Clearance00:56

One-Compartment Open Model for IV Bolus Administration: Estimation of Clearance

Clearance is a key pharmacokinetic parameter that quantifies the volume of body fluid from which a drug is entirely removed within a specific time frame. It is crucial in assessing how a drug is eliminated from the body and has critical clinical applications.
In the one-compartment open model for intravenous (IV) bolus administration, clearance is estimated by dividing the elimination rate by the plasma drug concentration. This equation leverages the elimination rate constant and the apparent...
140