Pharmacist-run service improves care for warfarin patients

A pharmacist-directed anticoagulation service greatly improved care for warfarin patients, reported a new study published in the July/August issue of the Journal of Hospital Medicine.

At the Henry Ford Hospital in Michigan, researchers examined 500 patients receiving warfarin, which is linked to an estimated 30% of anticoagulant-related medication errors. They found that the transition of care directed by the anticoagulation service was seamless in more than 70% of patients treated. Patients’ risk of bleeding and thrombosis declined by nearly 5%, compared to that of patients not treated with this anticoagulation service.

“Our pharmacist-directed anticoagulation service has been shown to improve the quality of care for patients taking warfarin in the hospital and transitioning to an outpatient setting. The advantage of this service is that it improved the patient transition, enhanced communication between inpatient and outpatient clinicians, and ensured that patients made it to their outpatient follow-up appointment after being discharged from the hospital,” said James Kalus, PharmD, senior clinical pharmacy manager at Henry Ford and senior author of the study.

To measure how well care was coordinated as patients transitioned from the hospital to the outpatient anticoagulation clinic, the researchers applied four key compliance metrics: the number of patients enrolled in an outpatient anticoagulation clinic, documented communications between the inpatient and outpatient anticoagulation clinics, documented communication between the inpatient anticoagulation service and the physician responsible for managing the patient at the outpatient anticoagulation clinic, and the number of patients who kept their first appointments with the outpatient anticoagulation clinic within 5 days of being discharged from the hospital.