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• W1533064851 abstract "ABSTRACT Objective: To evaluate the quality of oral anticoagulant monitoring by means of point-of-care testing in a community pharmacy, performed under the supervision of staff in a specialized hospital oral anticoagulation clinic. Methods: Participants consisted of patients receiving long-term warfarin therapy who were expected to require treatment for at least 3 months and who were patients of the hospital anticoagulation clinic or customers of the designated community pharmacy. The primary endpoint was the proportion of time for which international normalized ratio (INR) was within the expanded therapeutic range (within 0.2 INR units above or below the target therapeutic range) for 2 groups: patients who were managed through the community pharmacy and historical controls, whose treatment had been managed through oral anticoagulation clinics. Rates of thromboembolic and major hemorrhagic events and of patient satisfaction in the 2 groups were determined. Results: Nineteen patients were enrolled in this study and had their warfarin therapy managed by community pharmacists. The INR level was within the expanded therapeutic range 84% of the time (95% confidence interval [CI] 75% to 93%) for these patients and 82% of the time (95% CI 78% to 85%) for the historical controls managed through oral anticoagulation clinics (p = 0.58). No thromboembolic or bleeding events occurred in any of the 19 study participants. There was no difference between the groups in responses on patient satisfaction questionnaires. Conclusions: Community pharmacists using point-of-care testing under the supervision of staff in a hospital oral anticoagulation clinic provided warfarin management that was similar to warfarin management for historical controls attending oral anticoagulation clinics. The development of satellite anticoagulation clinics in community pharmacies may lead to a more individualized approach to therapy and eliminate the inconvenience of INR testing in hospital laboratories. Further studies of longer duration are required to determine whether community pharmacy management improves patient outcomes and is cost-effective. RESUME Objectif : Evaluer la qualite de la surveillance de l’anticoagulotherapie orale dans une pharmacie communautaire au moyen d’epreuves effectuees au point d’intervention et sous la supervision du personnel de la clinique d’anticoagulotherapie orale d’un hopital. Methodes : Les participants etaient des patients soit de la clinique d’anticoagulotherapie de l’hopital, soit des clients de la pharmacie communautaire designee et devaient recevoir un traitement prolonge a la warfarine d’une duree d’au moins trois mois. Le critere d’evaluation primaire etait le nombre de fois, exprime en pourcentage, ou le rapport international normalise (RIN) etait a l’interieur des limites de l’ecart therapeutique elargi (RIN superieur ou inferieur de 0,2 unite a l’ecart therapeutique vise) dans deux groupes : un groupe de patients qui ont ete pris en charge par la pharmacie communautaire et un groupe temoin historique dont le traitement avait ete pris en charge par des cliniques d’anticoagulotherapie orale. On a determine les taux de thromboembolie et d’hemorragies graves ainsi que la satisfaction des patients dans les deux groupes. Resultats : Dix-neuf patients, dont l’anticoagulotherapie a ete prise en charge par des pharmaciens communautaires, ont participe a cette etude. Le RIN de ces patients etait a l’interieur de l’ecart therapeutique elargi 84 % du temps (intervalle de confiance [IC] a 95 % de 75 % a 93 %), alors que chez les patients du groupe temoin historique pris en charge par le personnel de cliniques d’anticoagulotherapie orale, il l’etait 82 % du temps (IC a 95 % de 78 % a 85 %) (p = 0,58). Aucune thromboembolie ni hemorragie n’est survenue chez aucun des 19 participants a l’etude. On n’a observe aucune difference dans les reponses aux questions sur la satisfaction entre les deux groupes. Conclusions : La prise en charge du traitement a la warfarine par des pharmaciens communautaires ayant recours aux epreuves au point d’intervention sous la supervision du personnel de la clinique d’anticoagulotherapie orale d’un hopital etait equivalente a la prise en charge de ce traitement par des cliniques d’anticoagulotherapie orale. La mise en place de cliniques d’anticoagulotherapie satellites dans des pharmacies communautaires pourrait contribuer a personnaliser davantage le traitement et a eliminer les visites incommodes dans les laboratoires des hopitaux pour la determination du RIN. D’autres etudes a plus long terme sont necessaires afin de determiner si la prise en charge par les pharmacies communautaires ameliore les resultats therapeutiques et est efficiente." @default.
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• W1533064851 date "2004-01-01" @default.
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• W1533064851 title "A Pilot Study Evaluating the Feasibility of Monitoring Oral Anticoagulant Therapy with Point-of-Care Testing in a Community Pharmacy" @default.
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• W1533064851 doi "https://doi.org/10.4212/cjhp.v57i3.369" @default.
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