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Pharmacist warfarin

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https://www.readbyqxmd.com/read/27878205/iterative-development-and-evaluation-of-a-pharmacogenomic-guided-clinical-decision-support-system-for-warfarin-dosing
#1
Brittany L Melton, Alan J Zillich, Jason Saleem, Alissa L Russ, James E Tisdale, Brian R Overholser
OBJECTIVE: Pharmacogenomic-guided dosing has the potential to improve patient outcomes but its implementation has been met with clinical challenges. Our objective was to develop and evaluate a clinical decision support system (CDSS) for pharmacogenomic-guided warfarin dosing designed for physicians and pharmacists. METHODS: Twelve physicians and pharmacists completed 6 prescribing tasks using simulated patient scenarios in two iterations (development and validation phases) of a newly developed pharmacogenomic-driven CDSS prototype...
November 23, 2016: Applied Clinical Informatics
https://www.readbyqxmd.com/read/27864202/implementation-of-inpatient-models-of-pharmacogenetics-programs
#2
Larisa H Cavallari, Craig R Lee, Julio D Duarte, Edith A Nutescu, Kristin W Weitzel, George A Stouffer, Julie A Johnson
PURPOSE: The operational elements essential for establishing an inpatient pharmacogenetic service are reviewed, and the role of the pharmacist in the provision of genotype-guided drug therapy in pharmacogenetics programs at three institutions is highlighted. SUMMARY: Pharmacists are well positioned to assume important roles in facilitating the clinical use of genetic information to optimize drug therapy given their expertise in clinical pharmacology and therapeutics...
December 1, 2016: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27803999/use-of-an-extended-inr-follow-up-interval-for-veteran-patients-in-an-anticoagulation-clinic
#3
Andrea L Porter, Amanda R Margolis, Rebecca R Schoen, Carla E Staresinic, Cheryl A Ray, Christopher D Fletcher
A prospective, single-arm study of 50 participants evaluated an extended INR follow-up interval to determine the implementation feasibility and safety of an extended interval in Veterans on a stable dose of warfarin. A protocol was designed to allow for a rigorous, yet pragmatic evaluation of a 12-week INR follow-up interval. Feasibility was determined by study enrollment, retention, and participant achievement rates for the extended INR interval. Safety was determined by bleeding and thromboembolism rates...
November 1, 2016: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/27747717/warfarin-and-rivaroxaban-duplication-a-case-report-and-medication-error-analysis
#4
Julie A Fusco, Eric J Paulus, Alexandra R Shubat, Sharminara Miah
A 62-year-old African American man received unintentional duplicate anticoagulation therapy with warfarin 5 mg and rivaroxaban 20 mg daily for the treatment of recurrent pulmonary embolism. The patient presented to the anticoagulation clinic 6 days after hospital discharge with an International Normalized Ratio (INR) of 2.3 and he was instructed to continue warfarin 5 mg daily. Seven days later, he returned to the clinic with an INR >8.0 using a point-of-care device. He denied any signs or symptoms of bleeding...
December 2015: Drug Saf Case Rep
https://www.readbyqxmd.com/read/27729677/risk-factors-for-bleeding-in-hospitalized-patients-with-elevated-inr-no-vitamin-k-therapy-received-versus-vitamin-k-received
#5
Monique Mounce, Candace Essel, Tiffany Kim, Che Matthew Harris
BACKGROUND: Supratherapeutic international normalized ratio (INR) in patients on warfarin is a common side effect. Updated guidelines recommend against using vitamin K to correct INRs 4.5 to 10 in the absence of bleeding. The impact of compliance with updated guidelines during hospitalization has not been fully explored. METHODS: A retrospective, observational study was performed utilizing electronic medical records. The goal was to evaluate management of supratherapeutic INR values for medicine inpatients and identify differences in clinical outcomes among inpatients treated and not treated with vitamin K...
November 2015: Hospital Pharmacy
https://www.readbyqxmd.com/read/27716978/influence-of-successful-chronic-hepatitis-c-virus-treatment-with-ledipasvir-sofosbuvir-on-warfarin-dosing-requirements-in-four-veterans
#6
Sara R Britnell, Amy E Willets, Adam J Vanderman, Catherine L Woodard, Rachel B Britt
STUDY OBJECTIVE: To describe international normalized ratio (INR) trends and warfarin dosage adjustments required for four veterans who were receiving warfarin therapy and started treatment for hepatitis C virus (HCV) with ledipasvir/sofosbuvir with or without ribavirin. DESIGN: Case series. SETTING: Pharmacist-led anticoagulation clinic in a Veterans Affairs Health Care System. PATIENTS: Four patients aged 59-66 years who were receiving warfarin and had stable, therapeutic INRs and started ledipasvir/sofosbuvir therapy with or without ribavirin for HCV infection...
October 7, 2016: Pharmacotherapy
https://www.readbyqxmd.com/read/27677651/comparing-the-effectiveness-of-pharmacist-managed-warfarin-anticoagulation-with-other-models-a-systematic-review-and-meta-analysis
#7
REVIEW
S Zhou, X Y Sheng, Q Xiang, Z N Wang, Y Zhou, Y M Cui
WHAT IS KNOWN AND OBJECTIVE: Anticoagulation management services are well known to improve the quality of patient care and to reduce the rates of hospitalization and emergency department visits following adverse events related to anticoagulation therapy. The complexity of managing warfarin has led to the development of a variety of specialized models managed by pharmacists, physicians, nurses, and self-managed care. The aim of the study is to compare the effectiveness of pharmacist-managed anticoagulation control of warfarin with other models...
December 2016: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/27605320/pharmacist-prescribing-within-an-integrated-health-system-in-washington
#8
Roger Woolf, Amanda Locke, Catherine Potts
PURPOSE: Pharmacist prescribing as part of a collaborative drug therapy agreement (CDTA) within an integrated health system in Washington is described. SUMMARY: Virginia Mason Medical Center (VMMC) in Seattle, Washington, uses a team-based care model with broad-based CDTAs to provide quality patient care. The majority of patients are referred to the pharmacist after a diagnosis has been made and a clinical care plan has been started. The pharmacist manages the patient's care within his or her scope of practice as defined by state laws and further detailed by VMMC internal protocols...
September 15, 2016: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27543375/elevated-international-normalized-ratio-in-a-patient-taking-warfarin-and-mauby-a-case-report
#9
Maria Sorbera, Tina Joseph, Robert V DiGregorio
We describe a 70-year-old Haitian man who had been taking warfarin for 5 years for atrial fibrillation and pulmonary hypertension. This patient had his international normalized ratio (INR) checked in the pharmacist-run anticoagulation clinic and was followed monthly. Prior to the interaction, his INR was therapeutic for 5 months while taking warfarin 10.5 mg/d. The patient presented with an INR > 8.0. Patient held 4 days of warfarin and restarted on warfarin 8.5 mg/d. Two weeks later, his INR was 2.5. After continuing dose, patient presented 2 weeks later and INR was 4...
August 19, 2016: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/27540224/children-s-warfarin-clinic-an-audit-of-the-new-pharmacist-led-telephone-service-based-on-a-unique-computerised-system-compared-to-the-ward-based-paper-system
#10
Teresa Brooks, Jennifer Brown, Elaine Woolley
AIMS: To audit the new pharmacist-led telephone service for warfarin dosing and monitoring of INR, and compare it to the previous system. The previous system was based on the paediatric cardiology ward, dosing by junior medical staff to dose and documented on a paper system. Also to audit the parent satisfaction of the new system. METHODS: Search the computerised system to reveal 73 patients on warfarin with a total of 1547 INRs, and looked for any complications or out of range results...
September 2016: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/27499793/incidence-rate-and-pattern-of-clinically-relevant-potential-drug-drug-interactions-in-a-large-outpatient-population-of-a-developing-country
#11
Ehsan Nabovati, Hasan Vakili-Arki, Zhila Taherzadeh, Mohammad Reza Saberi, Ameen Abu-Hanna, Saeid Eslami
The objective of this study was to determine incidence rate, type, and pattern of clinically relevant potential drug-drug interactions (pDDIs) in a large outpatient population of a developing country. A retrospective, descriptive cross-sectional study was conducted on outpatients' prescriptions in Khorasan Razavi province, Iran, over 12 months. A list of 25 clinically relevant DDIs, which are likely to occur in the outpatient setting, was used as the reference. Most frequent clinically relevant pDDIs, most common drugs contributing to the pDDIs, and the pattern of pDDIs for each medical specialty were determined...
May 2016: Research in Pharmaceutical Sciences
https://www.readbyqxmd.com/read/27461367/modelling-the-cost-effectiveness-of-pharmacist-managed-anticoagulation-service-for-older-adults-with-atrial-fibrillation-in-singapore
#12
Wen Bing Brandon Chua, Hua Heng McVin Cheen, Ming Chai Kong, Li Li Chen, Hwee Lin Wee
Background Oral anticoagulation with warfarin is the cornerstone therapy in atrial fibrillation (AF) for stroke prevention. Multi-disciplinary anticoagulation management services have been shown to be cost-effective in the United States, Hong Kong and Thailand, but the findings are not readily generalizable to Singapore's healthcare system. Objective This study aimed to evaluate the cost-effectiveness of pharmacist-managed anticoagulation clinic (ACC) compared with usual care (UC) for the management of older adults with AF receiving oral anticoagulation with warfarin...
October 2016: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/27455999/going-beyond-administrative-data-retrospective-evaluation-of-an-algorithm-using-the-electronic-health-record-to-help-identify-bleeding-events-among-hospitalized-medical-patients-on-warfarin
#13
James P Moriarty, Paul R Daniels, Dennis M Manning, John G O'Meara, Narith N Ou, Tamara M Berg, Jordan D Haag, Daniel L Roellinger, James M Naessens
To reliably assess quality, a standardized electronic approach is needed to identify bleeding events. The study aims were the following: (1) clinically validate an electronic health record-based algorithm for bleeding and (2) assess interrater results to determine validity and reliability. Data were analyzed before and after implementation of a pharmacist-managed warfarin protocol. Bleeding was based on ≥2 of 3 criteria: (1) diagnosis indicating bleeding, (2) lab value decrease suggesting bleeding, and (3) blood product use...
July 25, 2016: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/27403212/advantages-of-a-warfarin-protocol-for-long-term-care-pharmacists-a-retrospective-cohort-study
#14
Randall Sargent, Cynthia Brocklebank, Helen Tam-Tham, Tyler Williamson, Patrick Quail, Diana Turner, Neil Drummond
BACKGROUND: Warfarin is an anticoagulant prescribed to 12% of long-term care residents to reduce the risk of thrombo-embolism. This study used indicators to compare warfarin management by pharmacists to usual care. METHODS: This was a retrospective cohort study comparing a pharmacist-managed warfarin protocol with usual care of qualified warfarin recipients at long-term care facilities (two protocol, one control) in Calgary, Alberta. We compared the proportion of international normalized ratio (INR) tests in the range 2...
June 2016: Canadian Geriatrics Journal: CGJ
https://www.readbyqxmd.com/read/27402230/atrial-fibrillation-patients-treated-with-long-term-warfarin-anticoagulation-have-higher-rates-of-all-dementia-types-compared-with-patients-receiving-long-term-warfarin-for-other-indications
#15
T Jared Bunch, Heidi T May, Tami L Bair, Brian G Crandall, Michael J Cutler, John D Day, Victoria Jacobs, Charles Mallender, Jeffrey S Osborn, Scott M Stevens, J Peter Weiss, Scott C Woller
BACKGROUND: The mechanisms behind the association of atrial fibrillation (AF) and dementia are unknown. We previously found a significantly increased risk of dementia in AF patients taking warfarin with a low percentage of time in therapeutic range. The purpose of this study was to determine the extent to which AF itself increases dementia risk, in addition to long-term anticoagulation exposure. METHODS AND RESULTS: A total of 10 537 patients anticoagulated with warfarin (target INR 2-3), managed by the Clinical Pharmacist Anticoagulation Service with no history of dementia were included...
July 2016: Journal of the American Heart Association
https://www.readbyqxmd.com/read/27351746/development-and-validation-of-an-oral-anticoagulation-knowledge-tool-akt
#16
Kehinde O Obamiro, Leanne Chalmers, Luke R E Bereznicki
BACKGROUND: Assessing and improving patients' anticoagulation knowledge can lead to better treatment outcomes. While validated knowledge instruments exist for use in people taking warfarin, these tools are not necessarily applicable to patients taking direct-acting oral anticoagulants. OBJECTIVE: To develop and validate an oral anticoagulation knowledge instrument that is applicable to all oral anticoagulant medications. METHODS: Ten anticoagulation experts participated in the development of the Anticoagulation Knowledge Tool to ensure content validity...
2016: PloS One
https://www.readbyqxmd.com/read/27328684/evaluation-of-the-role-and-usefulness-of-a-pharmacist-outpatient-service-for-patients-undergoing-monotherapy-with-oral-anti-cancer-agents
#17
Michio Kimura, Makiko Go, Mina Iwai, Eiseki Usami, Hitomi Teramachi, Tomoaki Yoshimura
INTRODUCTION: When rapid feedback to physicians must be provided, e.g. monitoring therapy with the oral anticoagulant warfarin or providing therapeutic support for patients undergoing cancer chemotherapy, the involvement of pharmacists is required for outpatients. We launched a pharmacist outpatient service for patients with cancer taking oral anti-cancer agents. We evaluated the role and usefulness of the pharmacist outpatient service for these patients undergoing oral monotherapy with anti-cancer agents...
June 20, 2016: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/27251646/patient-satisfaction-with-extended-interval-warfarin-monitoring
#18
Nicholas W Carris, Andrew Y Hwang, Steven M Smith, James R Taylor, Karen Sando, Jason Powell, Eric I Rosenberg, Marc S Zumberg, John G Gums, Eric A Dietrich, Katherine Vogel Anderson
Extended-interval monitoring of warfarin has been proposed to reduce follow-up burden and improve patient satisfaction. We aimed to make an initial assessment of anticoagulation satisfaction before and after an extended-interval warfarin monitoring intervention. We conducted a translational prospective single-arm pilot study of extended-interval warfarin monitoring in five pharmacist-managed anticoagulation clinics. Patients meeting CHEST guideline criteria for extended-interval warfarin monitoring began progressive extended-interval follow-up (6, 8, and 12 weeks thereafter)...
November 2016: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/27231795/pillbox-use-and-inr-stability-in-a-prospective-cohort-of-new-warfarin-users
#19
Stephanie Dumas, Etienne Rouleau-Mailloux, Nawal Bouchama, Halema Lahcene, Mario Talajic, Jean-Claude Tardif, Marie-José Gaulin, Sylvie Provost, Marie-Pierre Dubé, Sylvie Perreault
BACKGROUND: Warfarin, a frequently prescribed oral anticoagulant, is well known for its narrow therapeutic index. Adherence to warfarin may help to achieve a stable international normalized ratio (INR), but little data are available regarding the impact of using a pillbox as a potential adherence aid device. OBJECTIVE: To evaluate the association between pillbox use and time in therapeutic range (TTR) < 60% and INR instability pattern. METHODS: This study was based on a prospective cohort of 1,069 new warfarin users who initiated warfarin between May 2010 and July 2013 within 17 hospitals in Quebec, Canada...
June 2016: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/27212967/omega-3-polyunsaturated-fatty-acid-supplementation-in-the-prevention-of-cardiovascular-disease
#20
REVIEW
Courtney P Walz, Arden R Barry, Sheri L Koshman
INTRODUCTION: Omega-3 polyunsaturated fatty acids (PUFAs) have purported protective cardiovascular (CV) effects. We sought to assess the evidence available for the use of omega-3 PUFAs for the prevention of cardiovascular disease (CVD). METHODS: A systematic literature search was conducted using MEDLINE and EMBASE from 1999 to 2015. Placebo-controlled, randomized controlled trials (RCTs) that enrolled over 1000 patients with follow-up greater than 1 year and meta-analyses of RCTs were included...
May 2016: Canadian Pharmacists Journal: CPJ, Revue des Pharmaciens du Canada: RPC
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