Study on Impact of Clinical Pharmacist’s Interventions in the Optimal Use of Oral Anticoagulants in Stroke Patients
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Date
2013-02
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Publisher
Indian Journal of Pharmaceutical Sciences
Abstract
Anticoagulants are very useful medications but can also lead to haemorrhagic as well as thromboembolic
complications when not used correctly or without proper medical attention. Anticoagulant’s complex pharmacology
and pharmacokinetics contribute to its narrow margin of safety. Pharmacist’s unique knowledge of pharmacology,
pharmacokinetics and interactions makes them well‑suited to assist patients in maintaining safe and effective
anticoagulation. Successful anticoagulation therapy implies fewer incidences of therapeutic failures and bleeding
complications. The anticoagulation management service staffed by clinical pharmacists is a service established to
monitor and manage oral and parenteral anticoagulants. In this research work, 40 patients each were included in
the intervention and the control groups. In the intervention group, patient’s knowledge score on anticoagulation
increased from an average of 5.6±3.2 to 13.8±0.94 (P=0.000) after clinical pharmacist’s counselling, whereas in
the control group there was no significant improvement in patient’s baseline knowledge over the knowledge score
at the end of the study (8.0±1.59 vs. 8.3±2.6) (P=0.218). In the intervention group, 73.45% of the international
normalised ratio test results were within the therapeutic range, 8.45% supratherapeutic and 18.5% subtherapeutic
during the 6 months data collection period. The corresponding data for the control group were 53.2 (P=0.000),
18.4 (P=0.000) and 28.4% (P=0.002), respectively. Forty four adverse drug reactions (ADRs) related to anticoagulants
were identified in the intervention group as compared to 56 in the control group. These results revealed that the
clinical pharmacist’s involvement in the anticoagulation management improved the therapeutic outcome of patients
and demonstrate the benefits of clinical pharmacist guided anticoagulation clinics in India.
Description
Staff Publication
Keywords
Anticoagulation management in India,, clinical pharmacist,, international normalised ratio,, thromboembolism,, warfarin