Development and Evaluation of Anticoagulation Clinical Pharmacy Sevice for Ambulatory Patients in a Community Hospital

병원 외래환자를 대상으로 한 항응고임상약학업무의 개발과 평가에 대한 연구

  • Choi Soo Im (College of Pharmacy, sookmyung Women's University) ;
  • Shin Hyun Taek (College of Pharmacy, sookmyung Women's University) ;
  • Choi HaeMi (Department of Pharmacy, Samsung Medical Center) ;
  • Kim Jung Sun (Department of Pharmacy, Samsung Medical Center) ;
  • An JungSoon (Department of Pharmacy, Samsung Medical Center) ;
  • Choi Kyoung Eob (Department of Pharmacy, Samsung Medical Center)
  • Published : 1995.12.01

Abstract

Pharmacist-managed Anticoagulation Service(ACS) was estabilished and the effectiveness of warfarin monitoring by ACS in maintaining therapeutic INR was evaluated. The primary goal of ACS is to maximize the control of therapy, to maintain therapeutic INR and to decrease morbidity and hospitalization caused by inadequate dosage regimen. Clinical pharmacists performed chartreview, laboratory interpretation, recommendations for warfarin dosage adjustments, physician and patient education, and coordination of follow-up in ACS. Patients receiving warfarin sodium were evaluated via retrospective chart review. Sixty-two patients were referred to ACS by primary physicians were compared with 117 patients in the physician-amtrolled group. The ACS patients maintained $88.6\%$ in the therapeutic range for anticoagulant therapy and the control group maintained $63.7\%$, where the difference was statistically significant.(P<0.001) The ACS improved warfarin dose determination, PT stability, patient compliance and provided improved therapy compared with the control group. ACS offers safe and efficient anticoagulant therapy in the ambulatory setting.

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