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https://www.readbyqxmd.com/read/29785093/assessment-of-patients-warfarin-knowledge-and-anticoagulation-control-at-a-joint-physician-and-pharmacist-managed-clinic-in-china
#1
Xingang Li, Shusen Sun, Qiaoyu Wang, Buxing Chen, Zhigang Zhao, Xiaowei Xu
Purpose: Warfarin is a widely used anticoagulant with a narrow therapeutic index, and it requires close monitoring and adequate patient education. We aimed to assess the knowledge level regarding warfarin therapy among its users and to identify the factors that significantly influence anticoagulation control. Patients and methods: Patients attending the Warfarin Clinic at the Beijing Tiantan Hospital were enrolled in this study. Patients' knowledge on warfarin was assessed using a validated Anticoagulation Knowledge Assessment (AKA) questionnaire...
2018: Patient Preference and Adherence
https://www.readbyqxmd.com/read/29741099/economic-evaluation-of-prescribing-conventional-and-newer-oral-anticoagulants-in-older-adults
#2
Syed Shahzad Hasan, Chia Siang Kow, Louise E Curley, Darrin L Baines, Zaheer-Ud-Din Babar
Anticoagulants refer to a variety of agents that inhibit one or more steps in the coagulation cascade. Generally, clinical conditions that require the prescribing of an oral anticoagulant increase in frequency with age. However, a major challenge of anticoagulation use among older patients is that this group of patients also experience the highest bleeding risk. To date, economic evaluation of prescribing of anticoagulants that includes the novel or newer oral anticoagulants (NOACs) in older adults has not been conducted and is warranted...
May 9, 2018: Expert Review of Pharmacoeconomics & Outcomes Research
https://www.readbyqxmd.com/read/29713691/improving-inpatient-warfarin-therapy-safety-using-a-pharmacist-managed-protocol
#3
Paul R Daniels, Dennis M Manning, James P Moriarty, Juliane Bingener-Casey, Narith N Ou, John G O'Meara, Daniel L Roellinger, James M Naessens
Introduction: Safe management of warfarin in the inpatient setting can be challenging. At the Mayo Clinic hospitals in Rochester, Minnesota, we set out to improve the safety of warfarin management among surgical and non-surgical inpatients. Methods: A multidisciplinary team designed a pharmacist-managed warfarin protocol (PMWP) which designated warfarin dosing to inpatient pharmacists with guidance from computerised dosing algorithms. Ordering this protocol was ultimately designed as an 'opt out' practice...
2018: BMJ open quality
https://www.readbyqxmd.com/read/29705388/the-translation-of-knowledge-into-practice-in-the-management-of-atrial-fibrillation-in-singapore
#4
Fong Yeong Brigitte Woo, Toon Wei Lim, Wai San Wilson Tam
BACKGROUND: Atrial fibrillation (AF) is a clinically significant cardiac arrhythmia known to increase the risk of stroke by at least four times. Stroke-risk assessment and thromboprophylaxis are vital components in AF management. Guidelines are available to standardise AF management, but physicians' adherence to the recommended guidelines has been low. The aims were to: 1. Examine and compare the level of knowledge and current practice in AF management between cardiologists and non-cardiologist physicians in Singapore; 2...
March 12, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29699776/communication-networks-of-medication-management-in-an-ambulatory-care-setting
#5
Andrea L Kjos, Ginelle A Bryant
BACKGROUND: Systems approaches in healthcare address complexities of care related to medication safety. Adverse drug events can be prevented by communication between providers. Thus, methods that depict the structures and processes of communications are foundational for prevention efforts. Social network analysis is a methodology applied in healthcare settings to describe and quantify communication patterns. Knowledge of the structures and processes surrounding medication management communications will be useful to explain and intervene on related quality or safety outcomes...
April 12, 2018: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/29691843/a-systems-approach-to-identify-factors-influencing-adverse-drug-events-in-nursing-homes
#6
Ali Azeez Al-Jumaili, William R Doucette
The objectives of the study were to identify the incidence rate and characteristics of adverse drug events (ADEs) in nursing homes (NHs) using the ADE trigger tool and to evaluate the relationships between resident and facility work system factors and incidence of ADEs using the System Engineering Initiative for Patient Safety (SEIPS) model. The study used 2 observational quantitative methods, retrospective resident chart extraction, and surveys. The participating staff included Directors of nursing, registered nurses, certified nurse assistants (CNAs)...
April 24, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29642733/warfarin-patients-with-anemia-show-trend-of-out-of-range-international-normalized-ratio-frequency-with-point-of-care-testing-in-an-anticoagulation-clinic
#7
Christina E DeRemer, Bliss McMichael, Henry N Young
INTRODUCTION: Many factors influence international normalized ratio (INR); however, few studies have examined the impact of anemia in warfarin patients. The primary objective of this study was to explore the relationship between in-clinic anemia and the control of INR within an anticoagulation clinic. METHODS: A retrospective chart review was performed on a random sample of patients seen in an academic medical center pharmacy-managed anticoagulation clinic. Hemochron® Signature Elite machine was utilized to monitor point-of-care (POC) INR...
January 1, 2018: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29605947/impact-of-warfarin-discharge-education-program-on-hospital-readmission-and-treatment-costs
#8
Luigi Brunetti, Seung-Mi Lee, Nancy Doherty, David Suh, Jeong-Eun Kim, Sun-Hong Lee, Yong Chan Choi, Dong-Churl Suh
Background Although warfarin is highly effective, management of patients prescribed warfarin is complex due to its narrow therapeutic window. Objective To evaluate the impact of a formal warfarin discharge education program (WDEP) on hospital readmission and treatment costs in patients who received warfarin therapy. Setting Robert Wood Johnson University Hospital Somerset in Somerville, New Jersey, USA. Method In this interventional cohort study, patients were assigned to either the WDEP group or the usual care group...
March 31, 2018: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29569095/interventions-and-strategies-to-improve-oral-anticoagulant-use-in-patients-with-atrial-fibrillation-a-systematic-review-of-systematic-reviews
#9
REVIEW
Siok Shen Ng, Nai Ming Lai, Surakit Nathisuwan, Nathorn Chaiyakunapruk
INTRODUCTION: Anticoagulation therapy is the fundamental approach for stroke prevention in atrial fibrillation (AF) patients. Numerous systematic reviews comparing anticoagulation strategies have been published. We aim to summarize the efficacy and safety evidence of these strategies in AF patients from previously published systematic reviews. METHODS: We searched PubMed, EMBASE and Cochrane library from inception to Feb 24th, 2017, to identify systematic reviews and meta-analyses of randomized controlled trials that assessed interventions or strategies to improve oral anticoagulant use in AF patients...
March 22, 2018: Clinical Drug Investigation
https://www.readbyqxmd.com/read/29534986/peri-procedural-management-of-oral-anticoagulants-in-the-doac-era
#10
REVIEW
Geoffrey D Barnes, Erin Mouland
Peri-procedural management of oral anticoagulants can be complex and confusing for many providers. It involves a careful balance of a patient's thromboembolic risk and bleeding risk. For every patient chronically taking an oral anticoagulant who will be undergoing an elective procedure, a four step approach may be considered when creating a plan for the oral anticoagulant. (1) Does the oral anticoagulant need to stop for the procedure? (2) If yes, when should the oral anticoagulant be stopped pre-procedure? (3) Does the patient require a "bridging" parenteral anticoagulant? (4) When should anticoagulation be re-started post procedure? Based on the unique features of warfarin versus the direct oral anticoagulants (DOAC), a unique, personalized plan should be developed and tailored to the individual patient...
March 10, 2018: Progress in Cardiovascular Diseases
https://www.readbyqxmd.com/read/29474176/cost-effectiveness-of-warfarin-medication-therapy-adherence-clinic-versus-usual-medical-clinic-at-kuala-lumpur-hospital
#11
Subramaniam Thanimalai, Asrul Akmal Shafie, Mohamed Azmi Ahmad Hassali, Jeyaindran Sinnadurai
BACKGROUND: Systematic anticoagulation management clinic is recommended to manage patients on chronic warfarin therapy. In Malaysia, the service was introduced as warfarin medication therapy adherence clinic (WMTAC), which is managed by pharmacists with a physician advisory. OBJECTIVES: To assess the cost-effectiveness of WMTAC in comparison with usual medical clinic (UMC), which is managed by medical officers in Kuala Lumpur Hospital, a tertiary referral hospital in Malaysia...
July 17, 2017: Value in Health Regional Issues
https://www.readbyqxmd.com/read/29437014/drug-induced-epistaxis-an-often-neglected-adverse-effect
#12
Sara Meirinho, Ricardo Relvas, Gilberto Alves
BACKGROUND: Epistaxis is an active nose bleeding with a population occurrence of approximately 60%. Although epistaxis is a common clinical complaint, the majority of the cases are benign and caused by local induced factors (e.g., trauma and local inflammation). Nevertheless, it is also recognised that epistaxis can be induced after some drugs intake. AIMS: Due to the increasing use of drugs or drug combinations that potentially may induce epistaxis, this review aims to alert healthcare professionals for this often neglected adverse drug effect and its possible complications...
February 12, 2018: Current Drug Safety
https://www.readbyqxmd.com/read/29417080/new-indications-for-dabigatran-a-suggestion-from-a-drug-use-evaluation-study
#13
Farzaneh Ashrafi, Najmeh Rezaie, Sarah Mousavi
Objective: Dabigatran etexilate is a novel oral anticoagulant with several advantages over warfarin such as no need for routine monitoring and fewer drug interactions. This drug was added to our hospital's formulary in 2012. The objective of this study was to assess the rational drug use of dabigatran at a large teaching hospital. Methods: A prospective cross-sectional study was performed from November to June 2015 at Alzahra teaching hospital, Isfahan, Iran. All patients who received at least one dose of dabigatran were eligible for inclusion...
October 2017: Journal of Research in Pharmacy Practice
https://www.readbyqxmd.com/read/29415718/moving-anticoagulation-initiation-and-monitoring-services-into-the-community-evaluation-of-the-brighton-and-hove-community-pharmacy-service
#14
Samantha J Ingram, Charlotte L Kirkdale, Sian Williams, Elaine Hartley, Susan Wintle, Valerie Sefton, Tracey Thornley
BACKGROUND: As part of the NHS desire to move services closer to where people live, and provide greater accessibility and convenience to patients, Brighton and Hove Clinical Commissioning Group (CCG) underwent a review of their anticoagulation services during 2008. The outcome was to shift the initiation and monitoring service in secondary care for non-complex patients, including domiciliary patients, into the community. This was achieved via a procurement process in 2008 resulting in the Community Pharmacy Anticoagulation Management Service (CPAMs) managed by Boots UK (a large chain of community pharmacies across the United Kingdom)...
February 7, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29407629/effect-of-increased-time-in-the-therapeutic-range-on-atrial-fibrillation-outcomes-within-a-centralized-anticoagulation-service
#15
Elise Phelps, Thomas Delate, Daniel M Witt, Paul B Shaw, Kathleen H McCool, Nathan P Clark
BACKGROUND: Clinical pharmacy anticoagulation services have improved the quality of anticoagulant therapy and are associated with lower rates of bleeding and thromboembolism compared to usual care. Several studies have found that higher time-in-therapeutic range (TTR) during warfarin therapy is associated with better warfarin outcomes. However, whether increasing TTR over time within an established anticoagulation service is associated with further reduction in bleeding and thromboembolic outcomes is unknown...
March 2018: Thrombosis Research
https://www.readbyqxmd.com/read/29391010/a-multicenter-prospective-study-evaluating-the-impact-of-the-clinical-pharmacist-physician-counselling-on-warfarin-therapy-management-in-lebanon
#16
Nermine S Choumane, Diana N Malaeb, Bassem Malaeb, Souheil Hallit
BACKGROUND: Health care professionals (HCP) are known key elements of effective patient's counselling and education. For patients taking warfarin, education about the dose, side effects, and toxicity is clearly identified as a cornerstone of achieving improved health and quality of life. The study objective was to evaluate the patients' knowledge about warfarin and assess the impact of the health care professionals' counselling in enhancing patients' knowledge in achieving warfarin therapeutic outcomes...
February 1, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29317397/factors-associated-with-availability-of-anticoagulation-reversal-agents-in-rural-and-community-emergency-departments
#17
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
#18
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
#19
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)...
February 2018: 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
#20
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
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