The role of the clinical pharmacist in patient education and monitoring of patients under warfarin treatment
Yıl: 2019 Cilt: 23 Sayı: 6 Sayfa Aralığı: 1157 - 1163 Metin Dili: İngilizce İndeks Tarihi: 29-05-2020
The role of the clinical pharmacist in patient education and monitoring of patients under warfarin treatment
Öz: This study was carried out on patients who were under anticoagulation treatment with warfarin, at the outpatient cardiology clinic. The aim was to determine the effectiveness of pharmacist consultation, education, and intervention on each patient’s therapeutic results. A cross-sectional randomized trial has been done. Twenty-five patients were included in the study. The Oral Anticoagulation Knowledge (OAK) Test, Short Form-36 (SF-36) and Duke Anticoagulation Satisfaction Scale (DASS) were applied. Patients resumed their routine anticoagulation treatment and INR and complications were recorded during the study. Additionally, patients received patient education, consultation on lifestyle and anticoagulant usage issues from a pharmacist. The same tests were applied again to the patients on the 90th day of the study and the results were compared with the initial test. Maintenance of INR within the target range and complication rates were compared before and after the intervention. Pre-test and post-test results of the patients revealed statistically significant improvements on the physical and mental score components of the SF-36 (p = 0.001; p = 0.001), OAK test scores (p ≤ 0.001) and the (negative) “limitations” and “burdens” and “positive effects” components of the DASS (p = 0.005; p < 0.001; p = 0.001). The successful maintenance of INR within target range was significantly higher (p = 0.027). The positive effects of pharmacist consultation and education on therapeutic results were demonstrated
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Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
- Kernan WN, Ovbiagele B, Black HR, Bravata DM, Chimowitz MI et al. Guidelines for the prevention of stroke in patients with stroke and transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke. 2014; 45: 2160-2236. [CrossRef]
- Çelik A, İzci S, Kobat MA, Ateş AH, Çakmak A et al. The awareness, efficacy, safety, and time in therapeutic range of warfarin in the Turkish population: WARFARIN-TR. Anatol J Cardiol. 2016; 16: 595-599. [CrossRef]
- Chen W, Chen Y, Hsu P, Tsay F, Chan H et al. Gastrointestinal hemorrhage in warfarin anticoagulated patients: incidence, risk factor, management, and outcome. BioMed Res Int. 2014; 29: 1-7. [CrossRef]
- Holbrook A, Schulman S, Witt DM, Vandvik PO, Fish J et al. Evidence-based management of anticoagulant therapy: Antithrombotic Therapy and Prevention of Thrombosis, 9th ed: American College of Chest Physicians EvidenceBased Clinical Practice Guidelines. Chest. 2012; 141(2 Suppl): 152-184. [CrossRef]
- Hope KA, Havrda DE. Subtherapeutic INR values associated with a switch to generic warfarin. Ann Pharmacother. 2001; 35: 183–187. [CrossRef]
- Wittkowsky AK. Dietary supplements, herbs and oral anticoagulants: the nature of the evidence. J Thromb Thrombolysis. 2008; 25: 72–77. [CrossRef]
- Davis NJ, Billett HH, Cohen HW, Arnsten JH. Impact of adherence, knowledge, and quality of life on anticoagulation control. Ann Pharmacother. 2005; 39: 632–636. [CrossRef]
- Krittathanmakul S, Silapachote P, Pongwecharak J, U Wongsatit. Effects of pharmacist counseling on outpatients receiving warfarin at Songklanagarind Hospital. Songkla Med J. 2006; 24: 93-99.
- Rossiter J, Soor G, Telner D, Aliarzadeh B, Lake J. et al. A pharmacist-led point-of-care INR clinic: optimizing care in a family health team setting. Int J Family Med. 2013; 2013: 1-4. [CrossRef]
- Reinders TP, Steinke WE. Pharmacist management of anticoagulant therapy in ambulant patients. Am J Health-Syst Pharm. 1979; 36: 645-648.
- Choe HM, Kim J, Choi KE, Mueller BA. Implementation of the first pharmacist-managed ambulatory care anticoagulation clinic in South Korea. Am J Health-Syst Pharm 2002; 59: 872-874. [CrossRef]
- Dib J, Mohammed K, Momattin H, Alshehri AM. Implementation of pharmacist-managed anticoagulation clinic in a saudi arabian health center. Hospital Pharmacy. 2014; 49: 260-268. [CrossRef]
- Manji I, Pastakia SD, Do AN, Ouma MN, Schellhase E, et al. Performance outcomes of a pharmacist‐managed anticoagulation clinic in the rural, resource-constrained setting of Eldoret, Kenya. J Thromb Haemost. 2011; 9: 22152220. [CrossRef]
- Carvalho AR, Ciol MA, Tiu F, Rossi LA, Dantas RAS et al. Oral Anticoagulation: the impact of the therapy in healthrelated quality of life at six-month follow-up. RLAE. 2013; 21: 105-112. [CrossRef]
- Lakshmi R, James E, Kirthivasan R. Study on impact of clinical pharmacist’s interventions in the optimal use of oral anticoagulants in stroke patients. Indian J Pharm Sci. 2013;75: 53-59. [CrossRef]
- Collins S, Barber A, Sahm LJ. Pharmacist’s counselling improves patient knowledge regarding warfarin, irrespective of health literacy level. Pharmacy. 2014; 2: 114-123. [CrossRef]
- Stafford L, Tienen EC, Bereznicki LR, Peterson GM. The benefits of pharmacist delivered warfarin education in the home. IJPP. 2012; 20: 384-389. [CrossRef]
- Winans AR, Rudd KM, Triller D. Assessing anticoagulation knowledge in patients new to warfarin therapy. Ann Pharmacother. 2010; 44: 1152-1157. [CrossRef]
- Hosmane SR, Tucker J, Osman D, Williams S, Waterworth P. et al. Inpatient oral anticoagulation management by clinical pharmacists: safety and cost effectiveness. J Clin Med Res. 2010; 2: 90-92. [CrossRef]
- Zeolla MM, Brodeur MR, Dominelli A, Haines ST, Allie ND. Et al. Development and validation of an instrument to determine patient knowledge: the oral anticoagulation knowledge test. Ann Pharmacother. 2006; 40: 633-638. [CrossRef]
- Kocyigit H, Aydemir O, Fisek G, Ölmez N, Memiş AK. Et al. Kisa Form 36’nin Türkce Versiyonunun Güvenilirligi ve Gecerliligi. Ilac ve Tedavi Dergisi. 1999; 12: 102- 106.
- Beyth R, Quinn L, Landefeld C. A multicomponent intervention to prevent major bleeding complications in older patients receiving warfarin: A randomized, controlled trial. Ann Int Med. 2000; 133: 687–1395. [CrossRef]
- Khan TI, Kamali F, Kesteven P, Avery P, Wynne H. et al. The value of education and self monitoring in the management of warfarin therapy in older patients with unstable control of anticoagulation. Br J Haematol. 2004; 126: 557-564. [CrossRef]
- Tang EO, Lai CS, Lee KK, Wong RS, Cheng G. et al. Relationship between patients’ warfarin knowledge and anticoagulation control. Ann Pharmacother. 2003; 37: 34-39. [CrossRef]
- Walraven C, Jennings A, Oake N, Fergusson D, Forster AJ. Et al. Effect of study setting on anticoagulation control: a systematic review and metaregression. Chest. 2006; 129: 1155–1166. [CrossRef]
- Ramanath KV, Balaji DB, Nagakishore CH, Kumar SM, Bhanuprakash M. et al. A study on impact of clinical pharmacist interventions on medication adherence and quality of life in rural hypertensive patients. J Young Pharm. 2012; 4: 95-100. [CrossRef]
- Jennings DL, Ragucci KR, Chumney EC, Wessell AM. Impact of clinical pharmacist intervention on diabetes related quality-of-life in an ambulatory care clinic. Pharm Pract (Granada). 2007; 5: 169-173.
- Boddy C. Pharmacist involvement with warfarin dosing for inpatients. Pharm World. 2001; 23: 31-35.
- Roche-Nagle G, Chambers F, Nanra J, Bouchier-Hayes D, Young S. et al. Evaluation of patient knowledge regarding oral anticoagulants. Irish Medical Journal. 2003; 96: 211-213.
- Khudair IF, Hanssens YI. Evaluation of patients' knowledge on warfarin in outpatient anticoagulation clinics in a teaching hospital in Qatar. Saudi Med J. 2010; 31: 672-677
| APA | İZZETTİN F, ÇELİK S, Acar R, tezcan s, Aksoy N, Bektay M, SANCAR M (2019). The role of the clinical pharmacist in patient education and monitoring of patients under warfarin treatment. , 1157 - 1163. |
| Chicago | İZZETTİN Fikret Vehbi,ÇELİK Sevda,Acar Rezzan Deniz,tezcan songül,Aksoy Nilay,Bektay Muhammed Yunus,SANCAR MESUT The role of the clinical pharmacist in patient education and monitoring of patients under warfarin treatment. (2019): 1157 - 1163. |
| MLA | İZZETTİN Fikret Vehbi,ÇELİK Sevda,Acar Rezzan Deniz,tezcan songül,Aksoy Nilay,Bektay Muhammed Yunus,SANCAR MESUT The role of the clinical pharmacist in patient education and monitoring of patients under warfarin treatment. , 2019, ss.1157 - 1163. |
| AMA | İZZETTİN F,ÇELİK S,Acar R,tezcan s,Aksoy N,Bektay M,SANCAR M The role of the clinical pharmacist in patient education and monitoring of patients under warfarin treatment. . 2019; 1157 - 1163. |
| Vancouver | İZZETTİN F,ÇELİK S,Acar R,tezcan s,Aksoy N,Bektay M,SANCAR M The role of the clinical pharmacist in patient education and monitoring of patients under warfarin treatment. . 2019; 1157 - 1163. |
| IEEE | İZZETTİN F,ÇELİK S,Acar R,tezcan s,Aksoy N,Bektay M,SANCAR M "The role of the clinical pharmacist in patient education and monitoring of patients under warfarin treatment." , ss.1157 - 1163, 2019. |
| ISNAD | İZZETTİN, Fikret Vehbi vd. "The role of the clinical pharmacist in patient education and monitoring of patients under warfarin treatment". (2019), 1157-1163. |
| APA | İZZETTİN F, ÇELİK S, Acar R, tezcan s, Aksoy N, Bektay M, SANCAR M (2019). The role of the clinical pharmacist in patient education and monitoring of patients under warfarin treatment. Journal of research in pharmacy (online), 23(6), 1157 - 1163. |
| Chicago | İZZETTİN Fikret Vehbi,ÇELİK Sevda,Acar Rezzan Deniz,tezcan songül,Aksoy Nilay,Bektay Muhammed Yunus,SANCAR MESUT The role of the clinical pharmacist in patient education and monitoring of patients under warfarin treatment. Journal of research in pharmacy (online) 23, no.6 (2019): 1157 - 1163. |
| MLA | İZZETTİN Fikret Vehbi,ÇELİK Sevda,Acar Rezzan Deniz,tezcan songül,Aksoy Nilay,Bektay Muhammed Yunus,SANCAR MESUT The role of the clinical pharmacist in patient education and monitoring of patients under warfarin treatment. Journal of research in pharmacy (online), vol.23, no.6, 2019, ss.1157 - 1163. |
| AMA | İZZETTİN F,ÇELİK S,Acar R,tezcan s,Aksoy N,Bektay M,SANCAR M The role of the clinical pharmacist in patient education and monitoring of patients under warfarin treatment. Journal of research in pharmacy (online). 2019; 23(6): 1157 - 1163. |
| Vancouver | İZZETTİN F,ÇELİK S,Acar R,tezcan s,Aksoy N,Bektay M,SANCAR M The role of the clinical pharmacist in patient education and monitoring of patients under warfarin treatment. Journal of research in pharmacy (online). 2019; 23(6): 1157 - 1163. |
| IEEE | İZZETTİN F,ÇELİK S,Acar R,tezcan s,Aksoy N,Bektay M,SANCAR M "The role of the clinical pharmacist in patient education and monitoring of patients under warfarin treatment." Journal of research in pharmacy (online), 23, ss.1157 - 1163, 2019. |
| ISNAD | İZZETTİN, Fikret Vehbi vd. "The role of the clinical pharmacist in patient education and monitoring of patients under warfarin treatment". Journal of research in pharmacy (online) 23/6 (2019), 1157-1163. |
