Evaluation of a pharmacist vs. Haematologist-managed anticoagulation clinic: A retrospective cohort study
Introduction: Warfarin is the core component in the management of various thromboembolic disorders, which requires specialized expertise to optimize outcomes. There is limited data comparing a pharmacist vs. a haematologist-managed anticoagulation clinic in our setting, and in the Middle East. We ai...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2021-10-01
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| Series: | Saudi Pharmaceutical Journal |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1319016421001699 |
| _version_ | 1818355756794118144 |
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| author | Afnan Noor Mansoor A. Khan Ashraf Warsi Mohammed Aseeri Sherine Ismail |
| author_facet | Afnan Noor Mansoor A. Khan Ashraf Warsi Mohammed Aseeri Sherine Ismail |
| author_sort | Afnan Noor |
| collection | DOAJ |
| description | Introduction: Warfarin is the core component in the management of various thromboembolic disorders, which requires specialized expertise to optimize outcomes. There is limited data comparing a pharmacist vs. a haematologist-managed anticoagulation clinic in our setting, and in the Middle East. We aimed to evaluate the effectiveness and safety of a pharmacist vs. a haematologist-managed anticoagulation clinic in the Ambulatory Care Center at King Abdulaziz Medical City, Jeddah, Saudi Arabia. Methods: A retrospective cohort study was conducted from 2016 to 2018, which included adult patients who have been followed-up for at least six months and who received warfarin for an extended period. The primary outcome was the proportion of time the patients in the two arms were in the therapeutic range. The secondary outcomes were the differences in expanded time in the therapeutic range, as well as the frequency of bleeding and thromboembolic events between the two arms. Results: We enrolled 104 and 124 patients in the pharmacist and haematologist arms respectively. The median time in the therapeutic range for the pharmacist arm was 71.4%, IQR (60.8–83.8) vs. 65%, IQR (43.5–79.1), in the haematologist arm (p = 0.0049). The median expanded time in the therapeutic range was 86.4%, IQR (77.5–95.3) vs. 81.21%, IQR (67.1–93.3) in the pharmacist vs. haematologist arm (p = 0.015) respectively. Major bleeding events occurred in 5.7 % vs. 3.2 %, and thromboembolic events in 5.7% vs. 4%, in the pharmacist vs. haematologist arm respectively. Conclusions: Our results demonstrated that the time in the therapeutic range was significantly higher in the pharmacist arm, with no significant difference in bleeding and thromboembolic events compared to the haematologist arm. |
| first_indexed | 2024-12-13T19:46:23Z |
| format | Article |
| id | doaj.art-b894eda5e240456b9b54851c52934957 |
| institution | Directory Open Access Journal |
| issn | 1319-0164 |
| language | English |
| last_indexed | 2024-12-13T19:46:23Z |
| publishDate | 2021-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Saudi Pharmaceutical Journal |
| spelling | doaj.art-b894eda5e240456b9b54851c529349572022-12-21T23:33:33ZengElsevierSaudi Pharmaceutical Journal1319-01642021-10-01291011731180Evaluation of a pharmacist vs. Haematologist-managed anticoagulation clinic: A retrospective cohort studyAfnan Noor0Mansoor A. Khan1Ashraf Warsi2Mohammed Aseeri3Sherine Ismail4Pharmaceutical Care Department, Ministry of National Guard-Health Affairs, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Jeddah, Saudi ArabiaPharmaceutical Care Department, Ministry of National Guard-Health Affairs, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Jeddah, Saudi ArabiaHaematology Department, Ministry of National Guard-Health Affairs, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Jeddah, Saudi Arabia; Department of Medicine, Faculty of Medicine, Umm Alqura University, Makkah, Saudi ArabiaPharmaceutical Care Department, Ministry of National Guard-Health Affairs, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Jeddah, Saudi ArabiaPharmaceutical Care Department, Ministry of National Guard-Health Affairs, King Saud bin Abdulaziz University for Health Sciences, King Abdullah International Medical Research Center, Jeddah, Saudi Arabia; Corresponding author.Introduction: Warfarin is the core component in the management of various thromboembolic disorders, which requires specialized expertise to optimize outcomes. There is limited data comparing a pharmacist vs. a haematologist-managed anticoagulation clinic in our setting, and in the Middle East. We aimed to evaluate the effectiveness and safety of a pharmacist vs. a haematologist-managed anticoagulation clinic in the Ambulatory Care Center at King Abdulaziz Medical City, Jeddah, Saudi Arabia. Methods: A retrospective cohort study was conducted from 2016 to 2018, which included adult patients who have been followed-up for at least six months and who received warfarin for an extended period. The primary outcome was the proportion of time the patients in the two arms were in the therapeutic range. The secondary outcomes were the differences in expanded time in the therapeutic range, as well as the frequency of bleeding and thromboembolic events between the two arms. Results: We enrolled 104 and 124 patients in the pharmacist and haematologist arms respectively. The median time in the therapeutic range for the pharmacist arm was 71.4%, IQR (60.8–83.8) vs. 65%, IQR (43.5–79.1), in the haematologist arm (p = 0.0049). The median expanded time in the therapeutic range was 86.4%, IQR (77.5–95.3) vs. 81.21%, IQR (67.1–93.3) in the pharmacist vs. haematologist arm (p = 0.015) respectively. Major bleeding events occurred in 5.7 % vs. 3.2 %, and thromboembolic events in 5.7% vs. 4%, in the pharmacist vs. haematologist arm respectively. Conclusions: Our results demonstrated that the time in the therapeutic range was significantly higher in the pharmacist arm, with no significant difference in bleeding and thromboembolic events compared to the haematologist arm.http://www.sciencedirect.com/science/article/pii/S1319016421001699Hospital outpatient clinicsAnticoagulationInternational normalized ratioPharmacist(s)HaematologyWarfarin |
| spellingShingle | Afnan Noor Mansoor A. Khan Ashraf Warsi Mohammed Aseeri Sherine Ismail Evaluation of a pharmacist vs. Haematologist-managed anticoagulation clinic: A retrospective cohort study Saudi Pharmaceutical Journal Hospital outpatient clinics Anticoagulation International normalized ratio Pharmacist(s) Haematology Warfarin |
| title | Evaluation of a pharmacist vs. Haematologist-managed anticoagulation clinic: A retrospective cohort study |
| title_full | Evaluation of a pharmacist vs. Haematologist-managed anticoagulation clinic: A retrospective cohort study |
| title_fullStr | Evaluation of a pharmacist vs. Haematologist-managed anticoagulation clinic: A retrospective cohort study |
| title_full_unstemmed | Evaluation of a pharmacist vs. Haematologist-managed anticoagulation clinic: A retrospective cohort study |
| title_short | Evaluation of a pharmacist vs. Haematologist-managed anticoagulation clinic: A retrospective cohort study |
| title_sort | evaluation of a pharmacist vs haematologist managed anticoagulation clinic a retrospective cohort study |
| topic | Hospital outpatient clinics Anticoagulation International normalized ratio Pharmacist(s) Haematology Warfarin |
| url | http://www.sciencedirect.com/science/article/pii/S1319016421001699 |
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