title: Establishing community pharmacy-based anticoagulation education and monitoring programs.
abstract: OBJECTIVE
  To determine the process for establishing community pharmacy-based anticoagulation education and monitoring programs using fingerstick capillary whole blood testing.
  
  
  METHODS
  Pilot community-based intervention study using convenience sample of patients.
  
  
  METHODS
  Three community pharmacies with pre-established health education centers and laboratories certified for moderate complexity.
  
  
  METHODS
  26 patients were referred to the clinics by 2 primary care physicians for each pharmacy, most with a diagnosis of atrial fibrillation.
  
  
  METHODS
  Patient assessment, including adherence to prescribed regimens; changes in medication use, including prescription and nonprescription medications, vitamins, health foods, and nutrition supplements; changes in diet and ethanol consumption; assessment of adverse experiences; and needed changes in warfarin dosage.
  
  
  METHODS
  Percentage of international normalized ratio (INR) values within therapeutic range, major bleeding events, and thrombotic events.
  
  
  RESULTS
  A total of 21 patient charts were available for analysis. More than 80% of patients had INR values within their targeted range (+/- 0.2) 60% or more of the time, comparable with values reported for anticoagulation clinics. Of the 235 INR values obtained during the study, 75% were within the individualized targeted therapeutic range (e.g., 2 to 3 +/- 0.2). One patient experienced a major bleeding event related to an underlying cancer. None of the patients experienced a thrombotic event.
  
  
  CONCLUSIONS
  Community pharmacies can effectively implement an anticoagulation education and monitoring program.
authors.affiliation: Hospice Pharmacia, Philadelphia, PA 19103, USA.
authors.forename: C H
authors.initials: CH
authors.lastname: Knowlton
authors.forename: O V
authors.initials: OV
authors.lastname: Thomas
authors.forename: A
authors.initials: A
authors.lastname: Williamson
authors.forename: A R
authors.initials: AR
authors.lastname: Gammaitoni
authors.forename: W R
authors.initials: WR
authors.lastname: Kirchain
authors.forename: M L
authors.initials: ML
authors.lastname: Buttaro
authors.forename: S A
authors.initials: SA
authors.lastname: Zarus
mesh_terms: D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D010353:Patient Education as Topic; D010594:Pharmacies / Q000592:standards*; D010865:Pilot Projects; D011517:Prothrombin Time; D014481:United States
chemical_list: D000925:Anticoagulants