Key result
Hospital pharmacist intervention linked to higher warfarin TTR vs. usual care, reaching ~74%.
Why the study?
Time in therapeutic range control of warfarin therapy was negatively affected in NVAF patients with heart failure, and the effect of hospital pharmacist intervention on TTR control was unknown.
Does hospital pharmacist intervention improve time in therapeutic range (TTR) of warfarin therapy in Japanese NVAF patients with heart failure?
Cohort (n=57)
No
Does hospital pharmacist intervention improve time in therapeutic range (TTR) of warfarin therapy in Japanese NVAF patients with heart failure?
Hospital pharmacist intervention significantly improves the time in therapeutic range for warfarin therapy in patients with non-valvular atrial fibrillation and heart failure.
Pharmacist intervention was associated with higher TTR in NVAF patients with HF; leaves open whether routine adoption improves outcomes.
Background/Aims Our previous study showed that time in therapeutic range (TTR) control of warfarin therapy was negatively affected in non-valvular atrial fibrillation (NVAF) patients with heart failure. This study assesses the effect of intervention by hospital pharmacists on TTR control in Japanese NVAF patients with heart failure. Method This retrospective cohort study included NVAF patients with heart failure admitted and discharged from the cardiovascular internal medicine ward between March 2011 and July 2013. Participants were classified into two groups according to the instructions by hospital pharmacists and physicians (Intervention group) and by physicians only (Usual care group). The primary outcome was TTR. Secondary outcomes were major bleeding and minor bleeding. Results In total, 57 participants (35 males, 22 females; mean age: 69.7 years) were classified into the Intervention (n = 25) and Usual care (n = 32) groups. TTR within-therapeutic range was significantly higher and within sub-therapeutic range was significantly lower in the Intervention than the Usual care group. Major bleeding and minor bleeding were not significantly different between the two groups. Conclusion The intervention of hospital pharmacists with anticoagulation therapy can lead to proper use of warfarin, which can be useful when physicians prescribe warfarin. J. Med. Invest. 64: 266-271, August, 2017.
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An et al. (2017) conducted a cohort in Non-valvular atrial fibrillation with heart failure (n=57). Hospital pharmacist intervention vs. Usual care (physician instructions only) was evaluated on Time in therapeutic range (TTR) (p=0.0169). Hospital pharmacist intervention significantly improved the median time in therapeutic range (TTR) for warfarin therapy to 73.8% compared to 59.8% with usual care in patients with non-valvular atrial fibrillation and heart failure.
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