Abstract
BackgroundAnticoagulants are the cornerstone therapy for the management of venous thromboembolism (VTE) and atrial fibrillation (AF). Pharmacists should be confident and equipped with the skill and updated knowledge in managing anticoagulation therapy.ObjectiveTo explore self-reported confidence level of pharmacists, perceived reasons influencing their confidence and socio-demographic associated with high confidence level in the area of anticoagulation.MethodsA cross-sectional, self-administered questionnaire survey was carried out among fully registered pharmacists who work in selected government hospitals and clinics in Borneo, Malaysia, from January 2019 to February 2020.ResultsOverall, responses from 542 fully registered pharmacists were obtained. Proportion of respondents who claimed confident in providing necessary information to patient receiving warfarin (n = 479, 88.3%) was significantly higher (p < 0.001) compared to low molecular weight heparins (n = 317, 58.5%) and direct oral anticoagulants (n = 211, 38.9%). Respondents’ perceived reasons that may influence their confidence level include experience in dealing with anticoagulants’ cases (n = 469, 86.5%), knowledge on anticoagulants (n = 394, 72.7%) and knowledge on diseases needing anticoagulation therapy (n = 311, 57.4%). Practising as ward pharmacist and “always” dealing with anticoagulants during their practice were the socio-demographic that significantly associated with high confidence level of pharmacist in providing pharmaceutical care on all types of anticoagulants (p < 0.05).ConclusionPharmacists were found more confident in providing pharmaceutical care on warfarin compared to low molecular weight heparins and direct oral anticoagulants. Continuous educational and training programmes on the use of anticoagulants should be carried out to enhance pharmacists’ confidence in supporting patients’ care.
Highlights
Anticoagulants are the cornerstone therapy for the management of venous thromboembolism (VTE) and atrial fibrillation (AF) [1]
Pharmacists were found more confident in providing pharmaceutical care on warfarin compared to low molecular weight heparins and direct oral anticoagulants
In Malaysia’s government hospitals and clinics, pharmacist-initiated medication counselling session are given to patients who are newly started on warfarin, low molecular weight heparins (LMWHs) and direct oral anticoagulants (DOACs) [24, 25]
Summary
Anticoagulants are the cornerstone therapy for the management of venous thromboembolism (VTE) and atrial fibrillation (AF) [1]. Literatures have proven that the involvement of pharmacists in anticoagulation management has positive impact in improving safety and efficacy outcomes in patients taking warfarin [26] or receiving DOACs [27]. This study showed that pharmacists’ confidence level was significantly lower (p < 0.001) when advising patients on DOACs compared to VKA. Another study was carried out by Hamedi et al [29] aimed to assess the community pharmacists’ current practice, knowledge and confidence in supporting patient’s adherence on oral anticoagulants for stroke prevention in atrial fibrillation in London via online survey where 257 community pharmacists responded. The unfamiliarity and minimal exposure to DOAC is reflected in their knowledge and confidence Both studies did not assess the confidence level on advising LMWHs even though LMWHs are commonly used as parenteral anticoagulant especially in in-patient care. Pharmacists should be confident and equipped with the skill and updated knowledge in managing anticoagulation therapy
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