Largest study yet confirms benefits of clinical pharmacy managed anticoagulation service

James B. Groce III, Pharm.D., CACP
Edited for patients and caregivers by Marie B. Walker
May, 2005

A recent study looked at the care received by patients taking warfarin (brand name Coumadin). There were two groups of patients in the study. One group had patients who go to their physicians to have their dose of warfarin (Coumadin) changed. The other group had patients who have their warfarin (Coumadin) dose changed by an anticoagulation clinic.

Patients in the study who were cared for by anticoagulation clinic spent more time with their INRs in range. (If you are not sure what the INR is, you may click here to read Understanding the PT-INR Test.) Also, patients who were cared for by an anticoagulation clinic had fewer bleeding and clotting events. In other words, the patients who were cared for by an anticoagulation clinic did better.

This study is not the first to suggest that warfarin (Coumadin) patients do better when cared for by an anticoagulation clinic. So, what does this study mean? In general, patients cared for by an anticoagulation clinic do better. However, some physicians do an excellent job, and some clinics may do a poor job. If you go to your doctor and your INR is out of range a lot of the time, then you may want to talk to your doctor about involving an anticoagulation clinic in your care. Regardless of the setting you are in, remember that you can help keep your INR in range simply by communicating with your healthcare provider and keeping him/her informed of any changes in your life. For more information on what you can do to help keep your INR in range, click here to read our frequently asked warfarin (Coumadin) questions. If you want to know more about clinics in your area, the Anticoagulation Forum maintains a world-wide listing of clinics. You may click here to go to the clinic directory on the Anticoagulation Forum website.

If you would like to review a more detailed summary of this study, click here to review the summary posted for healthcare providers.

References

1. Witt DM, Sadler MA, Shanahan RA, et al. Effect of a centralized clinical pharmacy anticoagulation service on the outcomes of anticoagulation therapy. Chest 2005; 125:1515-1522.
   
   
2. Garabedian-Ruffalo SM, Gray DR, Sax MJ, et al. Retrospective evaluation of a pharmacist- managed anticoagulation clinic. Am J Hosp Pharm 1985; 42:304-308.
   
   
3. Wilt DM, Gums JG, Ahmed OI, et al. Outcome analysis of a pharmacist-managed anticoagulation service. Pharmacotherapy 1995; 15:732-739.
   
   
4. Chiquette E, Amato MG, Bussey HI. Comparison of an anticoagulation clinic with usual medical care: anticoagulation control, patient outcomes, and healthcare costs. Arch Intern Med 1998; 158:1641-1647.
   
   
5. Duriex P. Electronic medical alerts-so simple, so complex. N Engl J Med 2005; 352:1034-1036.