A Pharmacist-Led Point-of-Care INR Clinic: Optimizing Care in a Family Health Team Setting. (11th December 2013)

• Record Type: Journal Article
• Authors: Rossiter, Jennifer; Soor, Gursharan; Telner, Deanna; Aliarzadeh, Babak; Lake, Jennifer
• Other Names: Mitchell Geoffrey Academic Editor.
• Is Part Of: International journal of family medicine. Volume 2013(2013)
• Publication Date: 2013-12-11
• Subjects: Family medicine -- Periodicals; Family Practice; Family medicine; Periodical; Periodicals; Electronic journals; Fulltext; Internet Resources; Periodicals; 610.5
• DOI: 10.1155/2013/691454
• Languages: English
• ISSNs: 2090-2042

Abstract

Abstract : Purpose . Monitoring patients' international normalized ratio (INR) within a family medicine setting can be challenging. Novel methods of doing this effectively and in a timely manner are important for patient care. The purpose of this study was to determine the effectiveness of a pharmacist-led point-of-care (POC) INR clinic. Methods . At a community-based academic Family Health Team in Toronto, Canada, charts of patients with atrial fibrillation managed by a pharmacist with usual care (bloodtesting at lab and pharmacist follow up of INR by phone) from February 2008 to April 2008 were compared with charts of patients attending a weekly POC INR clinic from February 2010 to April 2010. Time in therapeutic range (TTR) was measured for both groups. Results . 119 patient charts were reviewed and 114 had TTR calculated. After excluding patients with planned inconsistent Coumadin use (20), such as initiating Coumadin treatment or stopping for a surgical procedure, the mean TTR increased from 64.41% to 77.09% with the implementation of the POC clinic. This was a statistically significant difference of 12.68% (CI: 1.18, 24.18; P = 0.03 ). Conclusion . A pharmacist-led POC-INR clinic improves control of anticoagulation therapy in patients receiving warfarin and should be considered for implementation in other family medicine settings.