Background Outpatient warfarin dosing and monitoring with telephonic anticoagulation management (TAM) could be an effective alternative to other more labor intensive management models. Objectives To evaluate the time in therapeutic range (TTR) and number of extreme INR values (<1.5 or >4.5) of a telephonic system of warfarin management for stable patients who currently utilized traditional anticoagulation management services (AMSs). Method A retrospective, observational cohort with three groups (1) patients transitioned from an office-based anticoagulation clinic to TAM, (2) patients continuously enrolled in office-based AMS, (3) patients continuously managed by usual physician care without specialized anticoagulation services (UPC). Data was collected for six months before and six months after transition. Results All groups demonstrated decreased TTR from baseline to active phase, with the TAM and AMS groups showing similar magnitude of reduction (-10.61 and -12.66% respectively) but UPC group producing a greater drop (-20.08%). The TAM and AMS groups had similar rates of extreme INR levels; UPC had higher numbers of extreme INRs in three of the four measurements. Conclusion Stable patients transitioned from office-based anticoagulation clinic to a telephonic model of management performed equally as well as those who continued traditional enrollment.

Objective. To develop, implement, and assess whether simulated patient case videos improve students' understanding of and attitudes toward cross-cultural communication in health care. Design. Third-year pharmacy students (N5159) in a health care communications course participated in a one-hour lecture and two-hour workshop on the topic of cross-cultural communication. Three simulated pharmacist-patient case vignettes highlighting cross-cultural communication barriers, the role of active listening, appropriate use of medical interpreters, and useful models to overcome communication barriers were viewed and discussed in groups of 20 students during the workshop. Assessment. A pre-lecture and post-workshop assessed the effect on students' understanding of and attitudes toward cross-cultural communication. Understanding of cross-cultural communication concepts increased significantly, as did comfort level with providing cross-cultural care. Conclusion. Use of simulated patient case videos in conjunction with an interactive workshop improved pharmacy students' understanding of and comfort level with cross-cultural communication skills and can be useful tools for cultural competency training in the curriculum.

Change in health status was the strongest predictor of non-therapeutic INR levels out of the investigational factors evaluated. Our study demonstrated that there are many aetiologies for non-therapeutic INR values that were not explained by our investigational factors.

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