An Audit Evaluating Anticoagulation Clinic Managed by Clinical Pharmacists in Jordan

Al-Omari, Nadia A.; Al-Momany, Nairooz H.; Ibrahim, Diana A.; Ayesh, Ruba B.; Al-Sarayreh, Hana A.; Al-Haqesh, Hiam S.

doi:10.12816/0021417

An Audit Evaluating Anticoagulation Clinic Managed by Clinical Pharmacists in Jordan

Document Type : Original Article

Authors

¹ Clinical Pharmacy, Queen Alia Heart Institute

² Clinical Pharmacy, Dirocterate of Royal Medical Services

³ BCs in Diet Therapy, Queen Alia Heart Institute,

⁴ Clinical Pharmacy, King Hussein Medical Center.

10.12816/0021417

Abstract

Background and Objectives :Warfarin is the most widely prescribed oral anticoagulant; it is highly effective for the treatment and prevention of venous and arterial thrombosis. The beneficial outcomes of warfarin therapy are dependent upon achieving and maintaining an optimal international normalized ratio (INR) therapeutic range. The aim of this study was to evaluate the impact of our newly established clinic at Queen Alia Heart Institute (QAHI) in the Royal Medical Services (RMS), Jordan.
Patients and Methods:An observational prospective study was carried out in a newly established anticoagulation clinic managed by two clinical pharmacists and one nutritionist in QAHI since September 2013 until June 2014. The patients (no= 250) who were on warfarin for at least two months referred to the clinic were included in our study. All patients or their care givers received a 45 minutes educational session and a warfarin booklet. Then they were followed up regularly for achieving and maintaining the target INR and developing any adverse events related either too high or low INR (>4.5 or <1.5, respectively).Results:The age range of this group of the patients who were referred to t he clinic was wide, 5-81 years. 65% of them were males, with the most common indications for Warfarin were aortic and mitral valves replacement, and atrial fibrillation.72% of the patients were not achieving therapeutic (T) INR 43% of them achieve the TINR within the first week, 28% within the second week, 17% within the third, 4% within the fourth and 8% exceeded 4 weeks. The proportion of time within TINR for all the patients during the whole period was 75%. Only 7% of the patients had low INR, <1.5 and 5% had high INR, >4.5 for one visit. No major thromboembolic or hemorrhagic events were reported.
Conclusion:The newly established clinic had achieved a considerable encouraging results and feedbacks in the short period of time since it had been established.

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