PMID: 19946388Dec 1, 2009Paper

Evaluation of a pharmacist-managed anticoagulation clinic: Improving patient care.

Open Medicine : a Peer-reviewed, Independent, Open-access Journal
Tammy J BungardRoss T Tsuyuki

Abstract

Anticoagulation management services (AMSs) are widely used for anticoagulation management in many countries. Our AMS is a pharmacist-run ambulatory clinic with a physician advisory committee that manages patients referred with complicated anticoagulation histories. This paper assesses the adequacy of anticoagulation, rates of anticoagulant-related events and associated health care resource utilization for patients before and after referral to our AMS. Consecutive patients referred to the AMS with 4 months of prior anticoagulation management who also had anticoagulation management for 4 months within the AMS were included in the evaluation. The primary endpoint was adequacy of anticoagulation (target international normalized ratio [INR] +/- 0.5). Secondary outcomes included adverse events requiring an emergency department (ED) visit or hospital stay. These were classified by International Classification of Diseases (ICD) codes as thromboembolic, hemorrhagic, or non-anticoagulant related. Health care system resource consumption data were collected as number of hours spent in an ED and hospitalization costs. A total of 125 patients were included: 57.6% were male, with a mean age of 62.9 (standard deviation [SD]) +/- 15.0 years. In...Continue Reading

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