Pharmacy-managed, Weight-based Heparin Protocol

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

“…Pilot studies of pharmacy-managed in-hospital therapy with unfractionated heparin (UFH) [14][15][16][17][18][19] were similar, in both design and outcome, to the warfarin pilot studies discussed previously. For example, several UFH protocol adherence studies used non-homogeneous, historical control groups to assess the primary endpoints of time to reach target activated partial thromboplastin time (APTT) and time within the APTT goal range; pharmacists achieved these endpoints more effectively than standard care (Table 2).…”

Implementing anticoagulation management by pharmacists in the inpatient setting

“…Published observations from individual institutions evaluating pharmacists' Am J Health-Syst Pharm-Vol 64 May 15, 2007 involvement in managing inpatient anticoagulation indicate consistent evidence of improved clinical outcomes while reducing the cost of therapy (Table 1). [2][3][4][5][6][7][8][9][10][11]16 In a recent report by Bond and Raehl, 17 the potential effect of pharmacist involvement in managing either UFH or warfarin was analyzed and the results provided additional evidence supporting the observations of the reports in Table 1. Hospitals with pharmacists providing management of either warfarin or heparin were observed to have signifi cantly (p < 0.001) lower anticoagulationrelated mortality, length of hospital stay, bleeding complications, blood transfusion requirements, and cost of therapy.…”

“…Ambulatory care pharmacist's have performed this function for years, 1 with more recent reports supporting pharmacists' involvement inside of the hospital. [2][3][4][5][6][7][8][9][10][11][12] The purpose of this article is to explore approaches for successful implementation of an inpatient anticoagulation program involving pharmacists. Two successful inpatient anticoagulation programs previously reported in Purpose.…”

Evaluation of 2 Nomogram-Based Strategies for Dosing Argatroban in Patients With Known or Suspected Heparin-Induced Thrombocytopenia

“…In addition, the studies examining the impact of anticoagulation services (ie, experts) on these outcomes standardized dosing via nomograms in their treatment arms. 18 Therefore, coupling the practical implications of not using nomograms and the data supporting the potential for nomograms to reduce the risk of bleeding and thromboembolic events, current national recommendations are to use dosing nomograms or protocols. 1,9 In summary, the results of this study indicate that there is a time advantage associated with our dosing nomogram based on predefined dosing increments (eg, 0.2 mg/kg/min) compared to one based on percentages.…”