March 1, 2007Annals of Pharmacotherapy

Cost-Justification of a Clinical Pharmacist-Managed Anticoagulation Clinic

Q: What is the clinical evidence from this study?

Study design: Cohort. Population: Anticoagulation therapy (n=52). Intervention: Clinical pharmacist-managed anticoagulation clinic (AC) vs. Control group. Primary outcome: Hospitalization days per patient-treatment-year.

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Key result

A clinical pharmacist-managed anticoagulation clinic reduced hospitalization days from 3.22 to 0.048 per patient-treatment-year compared to control, with a benefit:cost ratio of 6.55.

Why the study?

Does a clinical pharmacist-managed anticoagulation clinic improve therapeutic prothrombin times and reduce hospitalizations and costs in patients requiring anticoagulation?

Population

52 patients (n=26 in treatment group, n=26 in control group) requiring anticoagulation management

Comparison

Clinical pharmacist-managed anticoagulation clinic vs Control group (standard care)

Design

Cohort

Authors

DGDavid R. Gray SGSusan M. Garabedian‐Ruffalo SCSteven D. Chretien

Discussion

Member takes

Overview

May support pharmacist-managed anticoagulation clinics; leaves open need for randomized confirmation.

Key Points

To evaluate the clinical efficacy and economic cost-justification of a clinical pharmacist-managed anticoagulation clinic compared with routine care.
Reviewed outpatient and hospital records for 26 patients managed by a clinical pharmacist anticoagulation clinic (treatment group) and 26 standard care patients (control group).
Compared maintenance of therapeutic prothrombin times, complication-related hospitalization rates, and overall net financial savings.
Therapeutic prothrombin times were maintained significantly better in the treatment group than in the control group (p<0.001).
Pharmacist management significantly prevented hospitalizations for hemorrhage (p<0.05) and thromboembolism (p<0.005), reducing hospital days from 3.22 to 0.048 days per patient-treatment-year.
The clinic yielded net annual hospitalization savings of $211,776 with a benefit-to-cost ratio of 6.55.

Study Design

Type

Cohort (n=52)

Structured PICO

Does a clinical pharmacist-managed anticoagulation clinic improve therapeutic prothrombin times and reduce hospitalizations and costs in patients requiring anticoagulation?

Population

52 patients receiving anticoagulation therapy, evaluated for cost-benefit of a pharmacist-managed clinic.

Exposure

Clinical pharmacist-managed anticoagulation clinic (AC)

Comparator

Control group (standard care)

Outcome

Cost-benefit (benefit:cost ratio, net savings), maintenance of therapeutic prothrombin times, and hospitalizations resulting from hemorrhage or thromboembolic admissions

Main Result

Absolute Event Rate: 0.048% vs 3.22%

A clinical pharmacist-managed anticoagulation clinic is highly cost-effective, significantly improving time in therapeutic range and reducing hospitalizations for bleeding and thromboembolism.

Cite This Study

Gray et al. (2007) conducted a cohort in Anticoagulation therapy (n=52). Clinical pharmacist-managed anticoagulation clinic (AC) vs. Control group was evaluated on Hospitalization days per patient-treatment-year. A clinical pharmacist-managed anticoagulation clinic reduced hospitalization days from 3.22 to 0.048 per patient-treatment-year compared to control, with a benefit:cost ratio of 6.55.

synapsesocial.com/papers/6a75efd274b63c188eb20736 https://doi.org/10.1345/aph.140056

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March 1, 2007Annals of Pharmacotherapy

Cost-Justification of a Clinical Pharmacist-Managed Anticoagulation Clinic

View Full Paper

Ask AI

Bookmark

Key result

A clinical pharmacist-managed anticoagulation clinic reduced hospitalization days from 3.22 to 0.048 per patient-treatment-year compared to control, with a benefit:cost ratio of 6.55.

Why the study?

Does a clinical pharmacist-managed anticoagulation clinic improve therapeutic prothrombin times and reduce hospitalizations and costs in patients requiring anticoagulation?

Population

52 patients (n=26 in treatment group, n=26 in control group) requiring anticoagulation management

Comparison

Clinical pharmacist-managed anticoagulation clinic vs Control group (standard care)

Design

Cohort

Authors

DGDavid R. Gray SGSusan M. Garabedian‐Ruffalo SCSteven D. Chretien

Discussion

Member takes

Overview

May support pharmacist-managed anticoagulation clinics; leaves open need for randomized confirmation.

Key Points

To evaluate the clinical efficacy and economic cost-justification of a clinical pharmacist-managed anticoagulation clinic compared with routine care.
Reviewed outpatient and hospital records for 26 patients managed by a clinical pharmacist anticoagulation clinic (treatment group) and 26 standard care patients (control group).
Compared maintenance of therapeutic prothrombin times, complication-related hospitalization rates, and overall net financial savings.
Therapeutic prothrombin times were maintained significantly better in the treatment group than in the control group (p<0.001).
Pharmacist management significantly prevented hospitalizations for hemorrhage (p<0.05) and thromboembolism (p<0.005), reducing hospital days from 3.22 to 0.048 days per patient-treatment-year.
The clinic yielded net annual hospitalization savings of $211,776 with a benefit-to-cost ratio of 6.55.

Study Design

Type

Cohort (n=52)

Structured PICO

Does a clinical pharmacist-managed anticoagulation clinic improve therapeutic prothrombin times and reduce hospitalizations and costs in patients requiring anticoagulation?

Population

52 patients receiving anticoagulation therapy, evaluated for cost-benefit of a pharmacist-managed clinic.

Exposure

Clinical pharmacist-managed anticoagulation clinic (AC)

Comparator

Control group (standard care)

Outcome

Cost-benefit (benefit:cost ratio, net savings), maintenance of therapeutic prothrombin times, and hospitalizations resulting from hemorrhage or thromboembolic admissions

Main Result

Absolute Event Rate: 0.048% vs 3.22%

A clinical pharmacist-managed anticoagulation clinic is highly cost-effective, significantly improving time in therapeutic range and reducing hospitalizations for bleeding and thromboembolism.

Cite This Study

synapsesocial.com/papers/6a75efd274b63c188eb20736 https://doi.org/10.1345/aph.140056

Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

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