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Abstract Context: Managing patients on anticoagulant therapy, such as warfarin, can be challenging due to various factors. Implementing a specialized care model can be a useful strategy to address this issue. Studies have demonstrated that pharmacist-led anticoagulation therapy leads to improved outcomes. Aims: We aimed to assess the anticoagulation quality of warfarin therapy achieved by the implementation of a Clinical Pharmacist-led Anticoagulation Clinic at a cardiac center. Materials and Methods: In conjunction with the cardiac center, the hospital’s pharmaceutical care department established a clinic. The anticoagulation quality was evaluated by determining the time in the therapeutic range (TTR), which was calculated using the Rosendaal method. Data were collected from February 1, 2021, to July 31, 2022, in a retrospective manner. Statistical Analysis Used: Both descriptive and inferential analyses were performed and are presented as counts, percentages, and means ± standard deviation, as appropriate. A paired t test was used to compare the mean TTR, and the outcomes were logistically regressed against candidate factors. Statistical significance was set at P < 0.05. Results: A total of 66 patients were eligible for inclusion in the study. The mean TTR was 73.4% ± 21.1%, compared to 46.9% ± 29.5% before clinic implementation. After clinic implementation, the proportion of patients who were able to reach a TTR of ≥70% increased from 28.8% to 60.6%. During clinical pharmacist care, there was one major bleeding event (0.7%/year), nine minor bleeding events (6%/year), and one thromboembolic event (0.7%/year). Age, comorbidities, and warfarin dose were not found to affect the TTR. However, females had a reduced likelihood of a TTR ≥70% (95% confidence interval, 0.11–0.89; P = 0.029). Conclusions: A clinical pharmacist-led anticoagulation clinic was implemented successfully, which resulted in positive outcomes in patient care by achieving a good TTR (≥70%) and low warfarin-related adverse events.
Alotaibi et al. (Mon,) studied this question.