The development of drug-related problems and dosage adjustment record forms for patients taking warfarin

Abstract

According to the setting of warfarin clinic in Huahin Hospital in 2013, we have found the drug related problems (DRPs) too much, especially sub-therapeutic, overtherapeutic, non-compliance, drug interaction, and adverse drug reactions (ADRs). Moreover the international normalized ratio (INR) were reported in target range (2.0- 3.0) only in 29.9% of patients taking warfarin. Therefore, we have been developed the record form to help the doctor interview and document the patient demographic, investigate the DRPs, and adjust dose of warfarin before patient be seeing a doctor. After 18 months of development and apply the DRPs and dosage adjustment record forms in warfarin clinic, we found that 67.8% of patients have a normal targeted-INR range. And satisfaction of record forms have also been reported in 97.1%. Thus, the DRPs and dosage adjustment record forms for patients taking warfarin have a benefit. Interviewing patients, investigating of DRPs, adjusting warfarin dosage, and record to the form by pharmacist before seeing the doctor can enhance the effectiveness and safety for patients taking warfarin. Furthermore, pharmacists can educate and help patients more compliance. In conclusion, the development of record form is a tool to communicate and notify the doctor and multidisciplinary care team for enhancing an effectiveness and safety in warfarin clinic.