Reduction in warfarin adverse events requiring patient hospitalization after implementation of a pharmacist-managed anticoagulation service.
OBJECTIVE
To compare adverse events related to anticoagulation in patients assigned to a pharmacist-managed anticoagulation service versus those receiving usual care.


METHODS
Retrospective cohort analysis.


METHODS
Three hundred-bed community hospital.


METHODS
Four hundred twenty patients referred for anticoagulation management.


RESULTS
Primary outcomes were the number of adverse events requiring patient hospitalization and the number of patients experiencing such events. Secondary outcomes were the median length of hospital stay/admission and the total number of hospital days. The total numbers of adverse events requiring hospitalization were three for the pharmacist-managed group and 14 for the usual care group (p=0.0153). The number of patients experiencing an adverse event requiring hospitalization was also lower for the pharmacist-managed group than for the usual care group (3 vs 10, p = 0.0962). The median length of hospital stay associated with each adverse event was not significantly different between the two groups; however, the total number of hospital days accrued was higher in the usual care group.


CONCLUSIONS
At 6 months after discontinuation of the pharmacist-managed anticoagulation service, the frequency of adverse events increased significantly, resulting in both an increased number of hospitalizations and an increased number of hospital days accrued. This coordinated anticoagulation program using a pharmacist reduced warfarin-related complications.
Locke
Christy
C
Pharmacy Department, St. Joseph's Medical Center, Thomas J. Long School of Pharmacy and Health Sciences, University of the Pacific, Stockton, CA 95211, USA.
Ravnan
Susan L
SL
Patel
Rajul
R
Uchizono
James A
JA
D000367:Age Factors; D000368:Aged; D000553:Ambulatory Care / Q000379:methods*; D000925:Anticoagulants / Q000009:adverse effects*; D015331:Cohort Studies; D006745:Hospital Bed Capacity, 300 to 499; D006760:Hospitalization; D006764:Hospitals, Community; D006801:Humans; D007902:Length of Stay; D010593:Pharmaceutical Services; D012189:Retrospective Studies; D012307:Risk Factors; D014859:Warfarin / Q000009:adverse effects*
D000925:Anticoagulants; D014859:Warfarin