Impact of a Pharmacist-Led Warfarin to Direct Oral Anticoagulant Conversion Initiative during the COVID-19 Pandemic

Abstract

Purpose: To assess the impact of a pharmacist-led warfarin to DOAC conversion initiative during the COVID-19 pandemic. Methods: Patients who were prescribed warfarin and followed with the anticoagulation clinic for INR monitoring were assessed by outpatient clinical pharmacists as potential candidates for transition to DOACs from March-August 2020. Results: 530 patients were assessed for transition to DOACs, of which 373 (70.4%) were deemed by clinical pharmacists to be candidates for DOACs. Of the patients who were candidates for DOACs, 66 (17.7%) were transitioned from warfarin to a DOAC. Of the patients who transitioned to a DOAC, 59 (89.4%) remained on a DOAC after one year. Conclusion: Outpatient clinical pharmacists are an effective resource to help identify patients who are candidates for DOACs and assist with transition from warfarin. Further, high persistence rates with DOAC therapy after one year demonstrate the positive impact of the clinical pharmacist on medication adherence.

A model program for pharmacist‐managed healthcare delivery: A tixagevimab–cilgavimab (EVUSHELD) clinic at a Veterans Affairs healthcare system

“…1 During the coronavirus disease 2019 (Covid-19) pandemic, pharmacists have managed anticoagulation and provided care for chronic health conditions such as diabetes mellitus and chronic obstructive lung. [1][2][3][4] They have also administered vaccinations, conducted testing, and prescribed oral treatments against severe acute respiratory coronavirus-2 (SARS-Cov-2). Pharmacists were involved in planning, dispensing, and monitoring monoclonal antibody treatment of Covid-19 with bamlanivimab and casirvimab-imdevimab at both healthcare system and patient care levels throughout the United States of America (US).…”

“…Pharmacists are highly accessible healthcare providers who are well positioned, but under‐utilized for delivering services that improve the public's access to medical evaluations and treatments 1 . During the coronavirus disease 2019 (Covid‐19) pandemic, pharmacists have managed anticoagulation and provided care for chronic health conditions such as diabetes mellitus and chronic obstructive lung 1–4 . They have also administered vaccinations, conducted testing, and prescribed oral treatments against severe acute respiratory coronavirus‐2 (SARS‐Cov‐2).…”