title: A retrospective assessment comparing pharmacist-managed anticoagulation clinic with physician management using international normalized ratio stability.
abstract: To assess the rates of therapeutic international normalized ratio (INR) levels between pharmacist-managed clinics compared to traditional physician-management and to determine the variation in rates of therapeutic INR levels between pharmacist-managed clinic data compared to physician-management. Retrospective, randomized, chart review. Referral only, outpatient, pharmacist based anticoagulation clinic under a community based tertiary care health system. Sixty-four patients with at least 1 year's worth of visits to the pharmacist managed clinic were reviewed for INR stability. The average percentage of visits within the defined therapeutic range, was 71.1% for the physician-managed group versus 81.1% for the pharmacist-managed group (P < 0.0001). The estimated variance in average therapeutic INR rates was double for the physician-managed group (365.7) versus the pharmacist-managed group (185.2) (P = 0.004). The pharmacist-managed anti-coagulation clinic had higher rates of INRs determined to be therapeutic and also exhibited significantly less variability in therapeutic INR rates relative to the physician-managed service.
authors.affiliation: South University School of Pharmacy, St. Joseph's/Candler Health-System Anti-coagulation Clinic, 709 Mall Blvd, Savannah, GA 31406, USA. lgarton@southuniversity.edu
authors.forename: Lauren
authors.initials: L
authors.lastname: Garton
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Crosby
mesh_terms: D000554:Ambulatory Care Facilities / Q000592:standards*; D000925:Anticoagulants / Q000627:therapeutic use; D003625:Data Collection; D006801:Humans; D019934:International Normalized Ratio / Q000706:statistics & numerical data*; D010595:Pharmacists; D010820:Physicians; D020399:Practice Management / Q000592:standards* / Q000706:statistics & numerical data; D012189:Retrospective Studies; D000078329:Workforce
chemical_list: D000925:Anticoagulants