title: Pharmacy students provide care comparable to pharmacists in an outpatient anticoagulation setting.
abstract: OBJECTIVE
  To evaluate whether student participation in ambulatory clinics influenced the percentage of therapeutic international normalized ratio (INR) results among patients on chronic warfarin therapy.
  
  
  METHODS
  Medical records in outpatient anticoagulation clinics managed by pharmacists under physician protocol were reviewed retrospectively in 2 university-affiliated clinics in Amarillo and Lubbock, TX. Pharmacy student activities included patient interviews, vital sign measurements, fingersticks, counseling, and documentation. Patient visits were conducted by a precepted pharmacy student or a pharmacist without a student, and the INR was measured at the subsequent patient visit.
  
  
  RESULTS
  Records of 1,958 anticoagulation patient visits were reviewed; 865 patients were treated by pharmacists, and 1093 were treated by precepted students. The follow-up INR was therapeutic for 48.5% of third-year (P3) students' patients, 45.6% of fourth-year (P4) students' patients, 51.2% of residents' patients, and 44.7% of pharmacists's patients (p = 0.23). Eight variables were associated with the follow-up INR (baseline INR, warfarin noncompliance, held warfarin doses, a warfarin dosage adjustment, diet change, alcohol use, tobacco use, and any medication changes).
  
  
  CONCLUSIONS
  Student participation in the patient-care process did not compromise patient care and no significant difference in patient outcomes was found between patients in an anticoagulation clinic cared for by precepted students and those cared for by pharmacists.
authors.affiliation: Texas Tech University Health Sciences Center, School of Pharmacy, and Veterans Affairs North Texas Health Care System - Dallas, TX, USA. kavita.dalal@ttuhsc.edu
authors.forename: Kavita
authors.initials: K
authors.lastname: Dalal
authors.forename: Kenneth L
authors.initials: KL
authors.lastname: McCall
authors.forename: David S
authors.initials: DS
authors.lastname: Fike
authors.forename: Niambi
authors.initials: N
authors.lastname: Horton
authors.forename: April
authors.initials: A
authors.lastname: Allen
mesh_terms: D000554:Ambulatory Care Facilities; D000925:Anticoagulants / Q000627:therapeutic use*; D001778:Blood Coagulation Disorders / Q000188:drug therapy*; D002982:Clinical Clerkship; D015331:Cohort Studies; D003376:Counseling; D016903:Drug Monitoring; D005500:Follow-Up Studies; D006801:Humans; D019934:International Normalized Ratio; D016015:Logistic Models; D016017:Odds Ratio; D010349:Patient Compliance; D010593:Pharmaceutical Services / Q000592:standards*; D010595:Pharmacists; D011787:Quality of Health Care; D012189:Retrospective Studies; D012307:Risk Factors; D013339:Students, Pharmacy; D016896:Treatment Outcome; D014859:Warfarin / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D014859:Warfarin