Pharmacy-managed anticoagulation: Assessment of in-hospital efficacy and evaluation of financial impact and community acceptance

Abstract

The reported outcomes of pharmacy-managed in-hospital anticoagulation therapy appear at least equal, and sometimes superior, to those obtained through standard care; however, the lack of large well-designed trials prevents drawing definitive conclusions. Nevertheless, the continued and likely increased future need for anticoagulation in general and warfarin therapy in particular suggests that increased pharmacist involvement could enhance the quality of patient care.

Inpatient warfarin management: pharmacist management using a detailed dosing protocol

“…Prior studies have recommended pharmacist-managed inpatient services with daily monitoring and dosing to improve the safety and efficacy of warfarin therapy [15]. Removing this task from the physician and placing it with a team experienced in dosing, as shown by prior studies on pharmacy monitoring services [16], still requires daily physician oversight and dosing approval, as daily medication dosing without an approved protocol is outside the scope of practice for nurses and pharmacists. By using a detailed protocol approved by the institution, a pharmacist alone can order dosing.…”

Combined Short Course Low Molecular Weight Heparin and Calf Compression Therapy in Prevention of Deep Vein Thrombosis after Total Knee Replacement: A Randomized Prospective Study

“…Short course LMWH regimes further provide significant cost reductions (30-40% cost reduction) by lowering pharmaceutical expenses and reducing the use of community services involved in drug administration (e.g. community nurses, GP, carers) [32,33].…”

Improving Cost-Effectiveness of and Outcomes From Drug Therapy in Patients With Atrial Fibrillation in Managed Care: Role of the Pharmacist

“…Nevertheless, several studies reported that both these groups were generally supportive of such initiatives. 24 The cost-effectiveness of pharmacist-managed anticoagulation services has been demonstrated despite the need for costly resources. 20,22 The estimated annual cost savings from such services for patients receiving warfarin for a variety of indications, including AF, ranges from $1,621 to $4,072 per patient.…”