Clinical pharmacist directed anticoagulation monitoring services: a prospective ınterventional study

Background and Aims: Antithrombotic therapies are established as cornerstones of treatment for a wide variety of ischemic vascular diseases. The study aimed to develop clinical pharmacist directed anticoagulation monitoring services in the cardiology department at tertiary care referral super specialty hospital. Method: Prospective interventional study was conducted for 12 months in the cardiology inpatient setting of a private tertiary care referral hospital in the Malabar region of Kerala. Constituted to be in three phases, they are: assessment of the present anticoagulation related practices, the development and sharing of anticoagulation protocol and finally the intervention and implementation of the system. Results and Discussion: Monitoring of the treatment could enhance the drug selection approaches, improved adherence to clinical guidelines and health outcomes. Heparin was the commonly prescribed drug in the cardiology department which had the risk of thrombocytopenia and major bleed, whereas this risk was lesser with fondaparinux. Early detection of bleeding could prevent complications from happening to the patients. The collaboration of the clinical pharmacist into anticoagulation therapy influenced the physician to comply with the ACCP guideline. Conclusion: The clinical pharmacist directed anticoagulation monitoring services improved the overall medical status of the patient.