Networking for success

Abstract

To determine the process for establishing community pharmacy-based anticoagulation education and monitoring programs using fingerstick capillary whole blood testing.Pilot community-based intervention study using convenience sample of patients.Three community pharmacies with pre-established health education centers and laboratories certified for moderate complexity.26 patients were referred to the clinics by 2 primary care physicians for each pharmacy, most with a diagnosis of atrial-fibrillation.Patient assessment, including adherence to prescribed regimens; changes in medication use, including prescription and nonprescription medications, vitamins, health foods, and nutrition supplements; changes in diet and ethanol consumption; assessment of adverse experiences; and needed changes in warfarin dosage.Percentage of international normalized ratio (INR) values within therapeutic range, major bleeding events, and thrombotic events.A total of 21 patient charts were available for analysis. More than 80% of patients had INR values within their targeted range (i 0.2) 60% or more of the time, comparable with values reported for anticoagulation clinics. Of the 235 INR values obtained during the study, 75% were within the individualized targeted therapeutic range (e.g., 2 to 3 ± 0.2). One patient experienced a major bleeding event related to an underlying cancer. None of the patients experienced a thrombotic event.Community pharmacies can effectively implement an anticoagulation education and monitoring program.