Effects of Pharmaceutical Care in Patients Receiving Warfarin from the Warfarin Clinic at Sawanpracharak Hospital

Abstract

Objective: To study the effects of pharmaceutical care on knowledge regarding drug use among patients receiving warfarin, their INR levels, percentage of days with INR in the target range, the incidence of bleeding and thrombosis before and after the pharmaceutical care and satisfaction among patients receiving services from the warfarin clinic with the involvement from multidisciplinary team. Methods: This study was a quasi- experimental research collecting that data prospectively and retrospectively from all 87 patients receiving warfarin from the clinic at least 4 times and percentage of INR within the target less than or equal to 50% or experiencing adverse drug reactions before receiving services from the clinic, and continuing to receive services at least 4 times after receiving pharmaceutical care from the warfarin clinic at Sawanpracharak Hospital between January and May 2517 Results: Average score on knowledge regarding drug use before receiving counseling from pharmacists was 6.94±1.11 (out of the full score of 10). After receiving counseling, mean score increased to 9.09 ± 0.60 (P <0.001). Proportion of times the INR within the target range and percentage of days that the patient had an INR within the target range after counseling were significantly increased from 13.4% and 16.61±21.12% to 41.0% and 35.68±31.04% (P<0.001) respectively. Proportion of bleeding decreased from 2.68% to 1.15%. Proportion of thromboembolic events was also reduced from 1.15% to 0.38%. Majority of patients were very satisfied with the services from the clinic. Conclusion: Pharmaceutical care from warfarin clinic improved knowledge on drug use. Patients had more appropriate self-care and reduction of various complications