Outcomes of Providing Pharmaceutical Care during Home Visit in Patients Receiving Warfarin: A Randomized Controlled Trial
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Abstract
Objectives: To compare the outcomes of pharmaceutical care provision during home visits in patients with warfarin with those in patients with usual care. Methods: This randomized controlled trial was conducted in adult patients with 18 years old or over, being residents in Phupaman district and receiving at least one time of treatment with warfarin for a continuous period of no less than 3 months. Fifty-six participants were randomly allocated into experimental and control groups with 28 subjects per group. The study prospectively collected International Normalized Ratio (INR) and drug related problems (DRPs) before intervention and at 1, 2 and 3 months after intervention. Knowledge regarding warfarin in experimental group was measured at before intervention, immediately after intervention and at 1, 2 and 3 months after intervention. Results: At the baselines, patient characteristics were not significantly different between groups. At the end of the study, percentage of patients with INR within target range in experimental group was significantly higher than that in control group (75.00% and 46.43%, respectively; P=0.029). Mean score of knowledge in the experimental group was significantly higher than that of control group statistical (17.64±0.56 and 16.61±1.17, respectively; P<0.001). Percentage of time with INR being in therapeutic range (%TTR) at the end of the study in the experimental group tended to be higher than that in control group (59.52±34.38 and 51.19±41.06, respectively; P=0.414) but with no statistically significant differences. The reduction of DRPs tended to be larger in experimental group, compared to that in control group. Within experimental group, DRPs decreased and knowledge increased overtime (P<0.001 for both variables), while proportion of patients with INR within target range was higher but with no statistically significant differences. Conclusion: Pharmaceutical care provision during home visits increased proportion of patients with INR within target range and their knowledge regarding warfarin therapy, and decreased DRPs.
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ผลการวิจัยและความคิดเห็นที่ปรากฏในบทความถือเป็นความคิดเห็นและอยู่ในความรับผิดชอบของผู้นิพนธ์ มิใช่ความเห็นหรือความรับผิดชอบของกองบรรณาธิการ หรือคณะเภสัชศาสตร์ มหาวิทยาลัยสงขลานครินทร์ ทั้งนี้ไม่รวมความผิดพลาดอันเกิดจากการพิมพ์ บทความที่ได้รับการเผยแพร่โดยวารสารเภสัชกรรมไทยถือเป็นสิทธิ์ของวารสารฯ
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