Assessment of Pharmacist-run Anticoagulation Clinic in Rural Arizona

Abstract

OBJECTIVES: To assess the outcomes of care for patients enrolled in a pharmacist-run anticoagulation clinic. METHODS: A retrospective chart review was conducted of patients who received warfarin anticoagulation therapy management at the pharmacist-managed clinic at a community health center. To be eligible for the study patients had to be between the ages of 18-80 and have at least 6 recorded INRs during the first 6 months of treatment in the clinic. The patient data were reviewed for a time period of 24 weeks from the initial visit. The primary dependent variable was whether or not a patient’s INR is within range. Secondary outcomes included frequency of adverse events (blood in urine or stool). A data extraction form was used to collect patient demographics and initial INR values from the patient charts. An odds ratio was used to compare the proportion of INRs in range upon entry into the clinic and after 6 months of care in the clinic. In addition, outcomes were evaluated for differences by gender and age. RESULTS: Sixty-six patients were included in the study; 50% (33) were men and the average age was 55.9 years old (SD = 12.9 years). At baseline, 24 patients had INRs within the therapeutic range. Patients were 5 times more likely to have INRs in range (N = 49; OR = 5.04; p < 0.001) after 6 months of treatment in the pharmacist-managed clinic than at baseline. About 59% of men and 54% of women had INRs in range during 6 months of therapy in the clinic (p=0.326). Patients under 55 were in range about 55% of the time over 6 months, while patients over 55 were in range about 59% of the time (p=0.366). CONCLUSION: Patients enrolled in the pharmacist-run anticoagulation clinic were more likely to have therapeutic INRs after 6 months of care in the clinic compared to baseline.