Pharmacotherapeutic follow-up of patients on warfarin in primary care: randomized clinical trial

Abstract

Aim: To evaluate the impact of pharmacotherapeutic follow-up on bleeding, time in therapeutic range (TTR), thrombotic events, general adverse events, hospitalizations, drug interactions and average number of medications used in patients taking warfarin in the Brazilian public healthcare system. Methods: A randomized clinical trial was conducted with individuals divided into two groups (intervention group [pharmacotherapeutic follow-up] and control group) who received at-home visits over an eight-month period. Results: 38individuals (21 in the intervention group and 17 in the control group) concluded the study. Fewer number of cases of bleeding was found in the group that received pharmacotherapeutic follow-up, but no significant association was found between these variables. No significant association was found between pharmacotherapeutic follow-up and TTR. The intervention group had a greater frequency in the therapeutic range for capillary INR but not for laboratory INR. Reductions were found in the intervention group with regards to general adverse events, the use of medications and drug interactions, whereas no reduction was found in hospitalizations. Conclusions: Based on the findings of the present study, pharmacotherapeutic follow-up did not exert an influence on bleeding or TTR. However, reductions were found in adverse events and drug interactions, which can contribute to the rational use of medicines and could result in lower care costs for patients requiring blood thinners