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https://www.readbyqxmd.com/read/29317397/factors-associated-with-availability-of-anticoagulation-reversal-agents-in-rural-and-community-emergency-departments
#1
Brett A Faine, Julie Amendola, Jordan Homan, Azeemuddin Ahmed, Nicholas Mohr
PURPOSE: Results of a study of anticoagulation reversal agent availability in rural and community hospital emergency departments (EDs) are reported. METHODS: A cross-sectional telephone survey was conducted to test the hypothesis that anticoagulation reversal agents are not commonly stocked in low-volume EDs. In phase 1 of the study, a physician, pharmacist, or nurse manager at a sample of EDs in 1 state was surveyed to characterize anticoagulation reversal agent availability and the presence or absence of reversal protocols; in phase 2, follow-up qualitative interviews were conducted with hospital pharmacists selected by purposive sampling to identify barriers to availability...
January 15, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29297662/venous-thromboembolism-role-of-pharmacists-and-managed-care-considerations
#2
Tuesdy Horner, Charles E Mahan
Venous thromboembolism (VTE) includes deep vein thrombosis and pulmonary embolism. Anticoagulation is used in patients with VTE to reduce the risk of recurrent VTE and VTE-related death. The overall incidence of VTE is 1 to 2 per 1000 person-years. Long-term mortality for patients with VTE is poor, with 25% of patients not surviving 7 days and nearly 40% not surviving the first year. Coagulation disorders demand effective anticoagulant therapy to avoid complications, especially recurrent VTE and VTE-related death...
December 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/29283294/evaluating-the-role-of-clinical-pharmacists-in-pre-procedural-anticoagulation-management
#3
Akash Kataruka, Elizabeth Renner, Geoffrey D Barnes
OBJECTIVES: While physicians are typically responsible for managing perioperative warfarin, clinic pharmacists may improve pre-procedural decision-making. We assessed the impact of pharmacist-driven care for chronic warfarin-treated patients undergoing outpatient right heart catheterization (RHC). METHODS: 200 warfarin patients who underwent RHC between January 2012 and September 2015 were analyzed. Pharmacist-care (n = 79) was compared to the usual care model (n = 121)...
December 28, 2017: Hospital Practice (Minneapolis)
https://www.readbyqxmd.com/read/29198732/application-of-process-mapping-to-understand-integration-of-high-risk-medicine-care-bundles-within-community-pharmacy-practice
#4
Natalie M Weir, Rosemary Newham, Emma D Corcoran, Ashwag Ali Atallah Al-Gethami, Ali Mohammed Abd Alridha, Paul Bowie, Anne Watson, Marion Bennie
OBJECTIVE: The Scottish Patient Safety Programme - Pharmacy in Primary Care collaborative is a quality improvement initiative adopting the Institute of Healthcare Improvement Breakthrough Series collaborative approach. The programme developed and piloted High Risk Medicine (HRM) Care Bundles (CB), focused on warfarin and non-steroidal anti-inflammatories (NSAIDs), within 27 community pharmacies over 4 NHS Regions. Each CB involves clinical assessment and patient education, although the CB content varies between regions...
November 21, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/29189976/validation-of-knowledge-and-adherence-assessment-tools-among-patients-on-warfarin-therapy-in-a-saudi-hospital-anticoagulant-clinic
#5
Sireen Abdul Rahim Shilbayeh, Wejdan Ali Almutairi, Sarah Ahmed Alyahya, Nouf Hayef Alshammari, Eiad Shaheen, Alya Adam
Background Although it can result in serious complications due to its narrow therapeutic index, warfarin is widely used in the treatment and prevention of thromboembolic disorders. However, patients' adherence and knowledge are determinants of therapeutic success. Objective We sought to validate instruments to provide a reliable means of identifying gaps in patient understanding and nonadherence to inform targeted pharmacists' interventions to improve these measures. Methods A cross-sectional survey was conducted...
November 30, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29170877/oral-anticoagulant-dosing-administration-and-storage-a-cross-sectional-survey-of-canadian-health-care-providers
#6
Siavash Piran, Sam Schulman, Mohamed Panju, Menaka Pai
Direct oral anticoagulant (DOAC) use is increasing worldwide. However, if not taken or prescribed correctly, DOACs have serious side effects. It is crucial that healthcare providers (HCPs) offer patients accurate information and counselling around DOACs, to optimize safe and effective use. To assess knowledge around oral anticoagulant indication, dosing, storage, and administration, an electronic survey was distributed to HCPs across Canada from June to August 2017, with 18 questions on the practical use of oral anticoagulants...
November 23, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29170637/effect-of-standardized-warfarin-treatment-protocol-on-anticoagulant-effect-comparison-of-a-warfarin-medication-therapy-adherence-clinic-with-usual-medical-care
#7
Salihah Aidit, Yee Chang Soh, Chuan Seng Yap, Tahir M Khan, Chin Fen Neoh, Shazwani Shaharuddin, Yaman W Kassab, Rahul P Patel, Long C Ming
Objective: To evaluate the impact of pharmacist-led warfarin management and standardized treatment protocol. Methods: A retrospective cohort study was carried out in a cardiology referral hospital located in central Kuala Lumpur, Malaysia, from 2009 to 2014. The inclusion criteria were: adult patients who were diagnosed and treated for atrial fibrillation (AF) with warfarin, attended the warfarin medication therapy adherence clinic (WMTAC) for at least 12 weeks, and with at least four international normalized ratio (INR) readings...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29167146/impact-of-educational-intervention-on-management-of-periprocedural-anticoagulation
#8
Amy L Awker, Melissa A Bell, Megan McGraw, Mark A Klein
PURPOSE: The effect of education regarding new evidence in periprocedural anticoagulation, with a focus on reducing use in patients at only moderate thromboembolic risk, is presented. METHODS: A retrospective cohort analysis and quasiexperimental design were used. The initial review identified the current state of practice regarding bridging anticoagulation. Education was then provided to primary care providers and pharmacists on recent evidence. A subsequent review was completed to assess the impact of this education on clinical decision-making...
December 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29025143/cost-effectiveness-of-the-pharmacist-assisted-warfarin-monitoring-program-at-a-medical-center-in-taiwan
#9
Jen-Yu Chang, Chi-Chuan Wang, Hao-Cheng Kang, Li-Jiuan Shen, Chih-Fen Huang
Objective: To investigate the cost-effectiveness of the first patient self-paying pharmacist-assisted warfarin monitoring (PAWM) program in Taiwan. Design: A Markov model with a 1-month cycle length and a 20-year time horizon was employed in this study. The model is composed of the following eight states: three no-event states (i.e. 'subtherapeutic,' 'within therapeutic' and 'supratherapeutic' states), two serious adverse events (AEs) (i.e. bleeding and thromboembolism), two sequelae states and death...
August 22, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28954994/hospital-pharmacist-intervention-improves-the-quality-indicator-of-warfarin-control-a-retrospective-cohort-study
#10
Taesong An, Eiji Kose, Akihiko Kikkawa, Hiroyuki Hayashi
Background/Aims Our previous study showed that time in therapeutic range (TTR) control of warfarin therapy was negatively affected in non-valvular atrial fibrillation (NVAF) patients with heart failure. This study assesses the effect of intervention by hospital pharmacists on TTR control in Japanese NVAF patients with heart failure. Method This retrospective cohort study included NVAF patients with heart failure admitted and discharged from the cardiovascular internal medicine ward between March 2011 and July 2013...
2017: Journal of Medical Investigation: JMI
https://www.readbyqxmd.com/read/28932938/assessment-of-oral-anticoagulation-control-at-two-pharmacist-managed-clinics-in-brazil
#11
Rogério Guimarães de Lima Silva, Caryne Margotto Bertollo, Isadora Gonçalves Ferreira, Luisa Caldeira Brant, Maria Auxiliadora Parreiras Martins
Background Warfarin remains widely used by patients with cardiovascular diseases. When using warfarin, the quality of oral anticoagulation control is a critical determinant to minimize the risk of bleeding and thromboembolic events. Pharmacist engagement in patient care is relevant towards improving the quality of warfarin therapy. Objective To assess the quality of oral anticoagulation control measured by time in therapeutic range (TTR) at two pharmacist-managed anticoagulation clinics (AC). Method This study included adults with indication of continuous warfarin use...
December 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28887344/medication-therapy-disease-management-geisinger-s-approach-to-population-health-management
#12
Laney K Jones, Gerard Greskovic, Dante M Grassi, Jove Graham, Haiyan Sun, Michael R Gionfriddo, Michael F Murray, Kandamurugu Manickam, Douglas C Nathanson, Eric A Wright, Michael A Evans
PURPOSE: Pharmacists' involvement in a population health initiative focused on chronic disease management is described. SUMMARY: Geisinger Health System has cultivated a culture of innovation in population health management, as highlighted by its ambulatory care pharmacy program, the Medication Therapy Disease Management (MTDM) program. Initiated in 1996, the MTDM program leverages pharmacists' pharmacotherapy expertise to optimize care and improve outcomes. MTDM program pharmacists are trained and credentialed to manage over 16 conditions, including atrial fibrillation (AF) and multiple sclerosis (MS)...
September 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28869100/findings-from-a-rivaroxaban-program-for-acute-venous-thromboembolism-upon-emergency-department-discharge-with-focus-on-utility-of-commercially-available-dose-pack
#13
Aileen Chu, Jill Limberg
OBJECTIVE: To evaluate the impact of a rivaroxaban discharge initiative on the efficacy and safety of acute venous thromboembolism treatment in emergency department patients. PRACTICE INNOVATION: Patients discharged on rivaroxaban from the emergency department were provided extensive counseling along with a commercially-available medication dose pack by the ED pharmacist. Patients were contacted by phone until they had obtained outpatient follow-up and remained adherent to anticoagulation beyond the initial first month of treatment...
August 2, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28735551/quality-of-pharmacist-managed-anticoagulation-therapy-in-long-term-ambulatory-settings-a-systematic-review
#14
Beenish S Manzoor, Wei-Han Cheng, James C Lee, Ellen M Uppuluri, Edith A Nutescu
OBJECTIVE: To perform a systematic review to evaluate the quality of warfarin anticoagulation control in outpatient pharmacist-managed anticoagulation services (PMAS) compared with routine medical care (RMC). DATA SOURCES: MEDLINE, SCOPUS, EMBASE, IPA, CINAHL, and Cochrane CENTRAL, from inception to May 2017. Search terms employed: ("pharmacist-managed" OR "pharmacist-provided" OR "pharmacist-led" OR "pharmacist-directed") AND ("anticoagulation services" OR "anticoagulation clinic" OR "anticoagulation management" OR "anticoagulant care") AND ("quality of care" OR "outcomes" OR "bleeding" OR "thromboembolism" OR "mortality" OR "hospitalization" OR "length of stay" OR "emergency department visit" OR "cost" OR "patient satisfaction")...
July 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28709455/barriers-and-facilitators-to-reducing-frequent-laboratory-testing-for-patients-who-are-stable-on-warfarin-a-mixed-methods-study-of-de-implementation-in-five-anticoagulation-clinics
#15
Geoffrey D Barnes, Sevan Misirliyan, Scott Kaatz, Elizabeth A Jackson, Brian Haymart, Eva Kline-Rogers, Jay Kozlowski, Gregory Krol, James B Froehlich, Anne Sales
BACKGROUND: Patients on chronic warfarin therapy require regular laboratory monitoring to safely manage warfarin. Recent studies have challenged the need for routine monthly blood draws in the most stable warfarin-treated patients, suggesting the safety of less frequent laboratory testing (up to every 12 weeks). De-implementation efforts aim to reduce the use of low-value clinical practices. To explore barriers and facilitators of a de-implementation effort to reduce the use of frequent laboratory tests for patients with stable warfarin management in nurse/pharmacist-run anticoagulation clinics, we performed a mixed-methods study conducted within a state-wide collaborative quality improvement collaborative...
July 14, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28530526/warfarin-management-and-outcomes-in-patients-with-nonvalvular-atrial-fibrillation-within-an-integrated-health-care-system
#16
JaeJin An, Fang Niu, Chengyi Zheng, Nazia Rashid, Robert A Mendes, Diana Dills, Lien Vo, Prianka Singh, Amanda Bruno, Daniel T Lang, Paul T Le, Kristin P Jazdzewski, Gustavus Aranda
BACKGROUND: Warfarin is a common treatment option to manage patients with nonvalvular atrial fibrillation (NVAF) in clinical practice. Understanding current pharmacist-led anticoagulation clinic management patterns and associated outcomes is important for quality improvement; however, currently little evidence associating outcomes with management patterns exists. OBJECTIVES: To (a) describe warfarin management patterns and (b) evaluate associations between warfarin treatment and clinical outcomes for patients with NVAF in an integrated health care system...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28508324/impact-of-clinical-pharmacist-intervention-in-anticoagulation-clinic-in-sudan
#17
Nahid Osman Ahmed, Bashier Osman, Yassein Mohamed Abdelhai, Tariq Muhammed Hashim El-Hadiyah
Background Many trials have compared anticoagulation management provided by a pharmacist led anticoagulation clinic versus usual physician care showing the role for clinical pharmacist in the management of anticoagulant therapy, and demonstrating excellent outcomes. In Sudan, there is no published research evaluating the role of pharmacist in providing pharmaceutical care for patients taking warfarin. Objective The objective of the study is to assess the role of clinical pharmacist intervention in warfarin patients compared to usual medical care...
August 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28503837/efficacy-of-protocol-based-pharmacotherapy-management-on-anticoagulation-with-warfarin-for-patients-with-cardiovascular-surgery
#18
Y Katada, S Nakagawa, K Minakata, M Odaka, H Taue, Y Sato, A Yonezawa, Y Kayano, I Yano, T Nakatsu, K Sakamoto, K Uehara, H Sakaguchi, K Yamazaki, K Minatoya, R Sakata, K Matsubara
WHAT IS KNOWN AND OBJECTIVE: Anticoagulation therapy with warfarin requires periodic monitoring of prothrombin time-international normalized ratio (PT-INR) and adequate dose adjustments based on the data to minimize the risk of bleeding and thromboembolic events. In our hospital, we have developed protocol-based pharmaceutical care, which we called protocol-based pharmacotherapy management (PBPM), for warfarin therapy. The protocol requires pharmacists to manage timing of blood sampling for measuring PT-INR and warfarin dosage determination based on an algorithm...
May 15, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28503220/medication-reconciliation-errors-in-a-tertiary-care-hospital-in-saudi-arabia-admission-discrepancies-and-risk-factors
#19
Faizan Mazhar, Shahzad Akram, Yousif A Al-Osaimi, Nafis Haider
BACKGROUND: Medication reconciliation is a major component of safe patient care. One of the main problems in the implementation of a medication reconciliation process is the lack of human resources. With limited resources, it is better to target medication reconciliation resources to patients who will derive the most benefit from it. OBJECTIVE: The primary objective of this study was to determine the frequency and types of medication reconciliation errors identified by pharmacists performing medication reconciliation at admission...
January 2017: Pharmacy Practice
https://www.readbyqxmd.com/read/28452063/risk-factors-of-adverse-health-outcomes-after-hospital-discharge-modifiable-by-clinical-pharmacist-interventions-a-review-with-a-systematic-approach
#20
REVIEW
Benedict Morath, Tanja Mayer, Alexander Francesco Josef Send, Torsten Hoppe-Tichy, Walter Emil Haefeli, Hanna Marita Seidling
The present review assessed the evidence on risk factors for the occurrence of adverse health outcomes after discharge (i.e. unplanned readmission or adverse drug event after discharge) that are potentially modifiable by clinical pharmacist interventions. The findings were compared with patient characteristics reported in guidelines that supposedly indicate a high risk of drug-related problems. First, guidelines and risk assessment tools were searched for patient characteristics indicating a high risk of drug-related problems...
October 2017: British Journal of Clinical Pharmacology
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