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J Am Pharm Assoc (Wash). 1999 May-Jun;39(3):368-74. doi: 10.1016/s1086-5802(16)30445-4.

Establishing community pharmacy-based anticoagulation education and monitoring programs.

Journal of the American Pharmaceutical Association (Washington, D.C. : 1996)

M L Buttaro, A R Gammaitoni, W R Kirchain, C H Knowlton, O V Thomas, A Williamson, S A Zarus

Affiliations

  1. Hospice Pharmacia, Philadelphia, PA 19103, USA.

PMID: 10363464 DOI: 10.1016/s1086-5802(16)30445-4

Abstract

OBJECTIVE: To determine the process for establishing community pharmacy-based anticoagulation education and monitoring programs using fingerstick capillary whole blood testing.

DESIGN: Pilot community-based intervention study using convenience sample of patients.

SETTING: Three community pharmacies with pre-established health education centers and laboratories certified for moderate complexity.

PARTICIPANTS: 26 patients were referred to the clinics by 2 primary care physicians for each pharmacy, most with a diagnosis of atrial fibrillation.

INTERVENTION: Patient assessment, including adherence to prescribed regimens; changes in medication use, including prescription and nonprescription medications, vitamins, health foods, and nutrition supplements; changes in diet and ethanol consumption; assessment of adverse experiences; and needed changes in warfarin dosage.

MAIN OUTCOME MEASURES: Percentage of international normalized ratio (INR) values within therapeutic range, major bleeding events, and thrombotic events.

RESULTS: A total of 21 patient charts were available for analysis. More than 80% of patients had INR values within their targeted range (+/- 0.2) 60% or more of the time, comparable with values reported for anticoagulation clinics. Of the 235 INR values obtained during the study, 75% were within the individualized targeted therapeutic range (e.g., 2 to 3 +/- 0.2). One patient experienced a major bleeding event related to an underlying cancer. None of the patients experienced a thrombotic event.

CONCLUSION: Community pharmacies can effectively implement an anticoagulation education and monitoring program.

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