Pharmacist involvement with warfarin dosing for inpatients

Pharmacy World & Science : PWS
C Boddy

Abstract

This study audits the quality of medical inpatient maintenance anticoagulation control by junior doctors and evaluates the impact of the implementation of warfarin guidelines on the anticoagulation control achieved by doctors compared with that by a pharmacist. Introduction of warfarin guidelines made no significant difference to the anticoagulation control achieved by junior doctors. The pharmacist demonstrated significantly better (p < 0.001) therapeutic control than the doctors in the areas of anticoagulation control measured, namely international Normalised Ratios (INRs) less than two and greater than six and INRs within the therapeutic range. The pharmacist overall, maintained 58% of INRs within range compared to 15% by junior doctors, over a twelve week period. In addition, there was a major reduction in the number of INRs requested by the pharmacist. Extrapolated over a year, this would amount to approximately 3,500 fewer INR requests on the medical wards. The effect of pharmacist dosing was also demonstrated in the difference in timing of warfarin administration by nursing staff. A much larger percentage of doses (90%) was administered within one hour of the prescribed time, compared to junior doctors (15%). This study ...Continue Reading

Citations

May 8, 2008·The Annals of Pharmacotherapy·Paula J Biscup-HornKenneth M Shermock
May 15, 2007·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·William E Dager, Michael P Gulseth
Dec 24, 2008·Drugs & Aging·Charlotte L R VerrueRobert Vander Stichele
Jan 26, 2011·Age and Ageing·Mathumalar LoganathanAzeem Majeed
Feb 1, 2014·American Journal of Health-system Pharmacy : AJHP : Official Journal of the American Society of Health-System Pharmacists·Greg MaynardIan Jenkins
Sep 12, 2018·JBI Database of Systematic Reviews and Implementation Reports·Eng Whui PohElizabeth E Roughead
Aug 13, 2011·Journal of Hospital Medicine : an Official Publication of the Society of Hospital Medicine·Jessica SchilligJames S Kalus
Mar 13, 2012·Therapeutic Drug Monitoring·Tatiane Araujo Castro, Isabela Heineck

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