Challenges of Anticoagulation Management Service and Need of Establishing Pharmacist-Led Anticoagulation Clinic in Tertiary Care Teaching Hospital, Ethiopia: A Qualitative Study

Tamrat Assefa Tadesse,1,2 Alfoalem Araba Abiye,1 Sisay Endale,2 Dejuma Yadeta,3 Legese Chelkeba,1 Teferi Gedif Fenta2 1Department of Pharmacology & Clinical Pharmacy, School of Pharmacy College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; 2Department of Pharmaceutics and So...

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Main Authors: Tadesse TA, Abiye AA, Endale S, Yadeta D, Chelkeba L, Fenta TG
Format: Article
Language:English
Published: Dove Medical Press 2022-04-01
Series:Journal of Multidisciplinary Healthcare
Subjects:
Online Access:https://www.dovepress.com/challenges-of-anticoagulation-management-service-and-need-of-establish-peer-reviewed-fulltext-article-JMDH
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author Tadesse TA
Abiye AA
Endale S
Yadeta D
Chelkeba L
Fenta TG
author_facet Tadesse TA
Abiye AA
Endale S
Yadeta D
Chelkeba L
Fenta TG
author_sort Tadesse TA
collection DOAJ
description Tamrat Assefa Tadesse,1,2 Alfoalem Araba Abiye,1 Sisay Endale,2 Dejuma Yadeta,3 Legese Chelkeba,1 Teferi Gedif Fenta2 1Department of Pharmacology & Clinical Pharmacy, School of Pharmacy College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; 2Department of Pharmaceutics and Social Pharmacy, School of Pharmacy College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; 3Department of Internal Medicine, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, EthiopiaCorrespondence: Tamrat Assefa Tadesse, Email tamrat.assefa@aau.edu.etPupose: To explore the challenges of anticoagulation management (AMS) and assess the need for establishing a pharmacist-led anticoagulation clinic (PLAC) at Tikur Anbessa Specialized Hospital (TASH) in Addis Ababa, Ethiopia.Methods: We conducted a qualitative study at TASH. Using a semistructured interview guide, we interviewed 15 physicians from different specialties, heads of pharmacy and laboratory departments. We also included 20 patients to explore their general perceptions, and experiences with and challenges of AMS; and the need to implement PLAC in the hospital.Results: Only three physicians responded that they had protocols for initiating and maintaining warfarin dosing. Having protocols for venous thromboembolism (VTE) risk assessment, VTE prophylaxis and treatment, bleeding risk assessment, and contraindication to anticoagulant therapy were reported by seven, six, four, and three participants, respectively. Lack of trained healthcare professionals and a separate AMS clinic, inconsistency in INR testing and anticoagulant availability, and longer appointment times were the biggest challenges of the existing AMS, according to 80% of respondents. Fourteen patient respondents indicated that their satisfaction with the AMS was affected by long wait times and inconsistent availability of anticoagulants and INR testing. The head of the laboratory stated that the facilities for INR testing are inadequate and affect the quality of AMS and customer satisfaction, and supplemented by the head of the pharmacy by adding irregularities of supplies and inadequate counseling on anticoagulants. Respondents suggested that there is a need to establish a PLAC with well-adopted standard operating procedures, qualified manpower, adequate training of assigned staff, and sustained supply of anticoagulants and INR testing.Conclusion: The hospital’s AMS is not optimal to provide adequate services during the study period. Based on these findings and recommendations, the supporting literature, and the experiences of other facilities, the PLAC was established in TASH.Keywords: anticoagulation, need assessment, anticoagulation management service, pharmacist-led anticoagulation clinic, Ethiopia
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spelling doaj.art-f11e84c82add4dcd964f2e796fbf24882022-12-21T23:28:14ZengDove Medical PressJournal of Multidisciplinary Healthcare1178-23902022-04-01Volume 1574375474279Challenges of Anticoagulation Management Service and Need of Establishing Pharmacist-Led Anticoagulation Clinic in Tertiary Care Teaching Hospital, Ethiopia: A Qualitative StudyTadesse TAAbiye AAEndale SYadeta DChelkeba LFenta TGTamrat Assefa Tadesse,1,2 Alfoalem Araba Abiye,1 Sisay Endale,2 Dejuma Yadeta,3 Legese Chelkeba,1 Teferi Gedif Fenta2 1Department of Pharmacology & Clinical Pharmacy, School of Pharmacy College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; 2Department of Pharmaceutics and Social Pharmacy, School of Pharmacy College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia; 3Department of Internal Medicine, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, EthiopiaCorrespondence: Tamrat Assefa Tadesse, Email tamrat.assefa@aau.edu.etPupose: To explore the challenges of anticoagulation management (AMS) and assess the need for establishing a pharmacist-led anticoagulation clinic (PLAC) at Tikur Anbessa Specialized Hospital (TASH) in Addis Ababa, Ethiopia.Methods: We conducted a qualitative study at TASH. Using a semistructured interview guide, we interviewed 15 physicians from different specialties, heads of pharmacy and laboratory departments. We also included 20 patients to explore their general perceptions, and experiences with and challenges of AMS; and the need to implement PLAC in the hospital.Results: Only three physicians responded that they had protocols for initiating and maintaining warfarin dosing. Having protocols for venous thromboembolism (VTE) risk assessment, VTE prophylaxis and treatment, bleeding risk assessment, and contraindication to anticoagulant therapy were reported by seven, six, four, and three participants, respectively. Lack of trained healthcare professionals and a separate AMS clinic, inconsistency in INR testing and anticoagulant availability, and longer appointment times were the biggest challenges of the existing AMS, according to 80% of respondents. Fourteen patient respondents indicated that their satisfaction with the AMS was affected by long wait times and inconsistent availability of anticoagulants and INR testing. The head of the laboratory stated that the facilities for INR testing are inadequate and affect the quality of AMS and customer satisfaction, and supplemented by the head of the pharmacy by adding irregularities of supplies and inadequate counseling on anticoagulants. Respondents suggested that there is a need to establish a PLAC with well-adopted standard operating procedures, qualified manpower, adequate training of assigned staff, and sustained supply of anticoagulants and INR testing.Conclusion: The hospital’s AMS is not optimal to provide adequate services during the study period. Based on these findings and recommendations, the supporting literature, and the experiences of other facilities, the PLAC was established in TASH.Keywords: anticoagulation, need assessment, anticoagulation management service, pharmacist-led anticoagulation clinic, Ethiopiahttps://www.dovepress.com/challenges-of-anticoagulation-management-service-and-need-of-establish-peer-reviewed-fulltext-article-JMDHanticoagulationneed assessmentanticoagulation management servicepharmacist-led anticoagulation clinicethiopia
spellingShingle Tadesse TA
Abiye AA
Endale S
Yadeta D
Chelkeba L
Fenta TG
Challenges of Anticoagulation Management Service and Need of Establishing Pharmacist-Led Anticoagulation Clinic in Tertiary Care Teaching Hospital, Ethiopia: A Qualitative Study
Journal of Multidisciplinary Healthcare
anticoagulation
need assessment
anticoagulation management service
pharmacist-led anticoagulation clinic
ethiopia
title Challenges of Anticoagulation Management Service and Need of Establishing Pharmacist-Led Anticoagulation Clinic in Tertiary Care Teaching Hospital, Ethiopia: A Qualitative Study
title_full Challenges of Anticoagulation Management Service and Need of Establishing Pharmacist-Led Anticoagulation Clinic in Tertiary Care Teaching Hospital, Ethiopia: A Qualitative Study
title_fullStr Challenges of Anticoagulation Management Service and Need of Establishing Pharmacist-Led Anticoagulation Clinic in Tertiary Care Teaching Hospital, Ethiopia: A Qualitative Study
title_full_unstemmed Challenges of Anticoagulation Management Service and Need of Establishing Pharmacist-Led Anticoagulation Clinic in Tertiary Care Teaching Hospital, Ethiopia: A Qualitative Study
title_short Challenges of Anticoagulation Management Service and Need of Establishing Pharmacist-Led Anticoagulation Clinic in Tertiary Care Teaching Hospital, Ethiopia: A Qualitative Study
title_sort challenges of anticoagulation management service and need of establishing pharmacist led anticoagulation clinic in tertiary care teaching hospital ethiopia a qualitative study
topic anticoagulation
need assessment
anticoagulation management service
pharmacist-led anticoagulation clinic
ethiopia
url https://www.dovepress.com/challenges-of-anticoagulation-management-service-and-need-of-establish-peer-reviewed-fulltext-article-JMDH
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