OBJECTIVES: To identify approaches and to evaluate efficacy of implementing an warfarin service program involving pharmacists. METHODS: The pharmacy department worked with the medical staff to establish a warfarin service, including guidelines approval. Pharmacist-managed warfarin service was provided in neurology ward or for patients who were referred from physicians, and others remained standard care of anticoagulants. Data was collected for 3 months after the service implementation (March to May, 2011). Demographic and clinical characteristics as well as laboratory and clinical data were retrieved from institutional electronic databases and compared between the pharmacist-managed and standardcare cohort. Comparisons between study groups were conducted using a chi2 or Fisher's Exact test for categorical variables and a two sample t-test or Wilcoxon rank sum test for continuous variables. RESULTS: INR below the therapeutic range were observed less frequently (53.3% vs. 61.1%, P=0.35) and better control for INR within range were reported more (28.6% vs. 26.9%, P=0.80) in pharmacist-managed arm, when compared to standard-care arm. There were also fewer number of patients never reaching the INR goal during the whole study period (35.7% vs. 46.1%, P=0.52). None of major bleeding event occurred, however, one thrombotic event was observed in each arm. By intervention of pharmacists, possible adverse event and medication errors were also blocked. For example, one patient discharged while INR over 5 without any physicians' or nurses' awareness was actively informed by pharmacist, then contacted to be cautious with possible bleeding risks and management. CONCLUSIONS: Pharmacist-managed warfarin service had a positive impact on anticoagulation management. This study provides further evidence to support the of role pharmacists in anticoagulant therapy. We plan to expend the warfarin service experience to the overall institution in the future.
Wang, Y. P., Tseng, J. H., & Huang, S. Y. (2012). PCV7 Implementing and Evaluating Pharmacist-Managed Warfarin Service in Inpatient and Outpatient Setting in Taiwan. Value in Health, 15(7), A630. https://doi.org/10.1016/j.jval.2012.08.178