Pharmacist warfarin

Background: Individualized pharmaceutical care, which consists of therapeutic drug monitoring (TDM), pharmacogenetic (PGx) testing and pharmacist-managed clinic (PMC), is one of the most important trends in clinical pharmacy development in the future. While relevant studies in China were primarily single-center or regional. This study aims to explore the current status of individualized pharmaceutical care in China, find out the existing problems and provide references for its further development. Methods: An electronic questionnaire was used and national hospitals' pharmaceutical administration data from January to December 2019 were collected...

Background: Direct oral anticoagulants (DOACs) are increasingly prescribed for the treatment of venous thromboembolism (VTE). However, little is known regarding pharmacists' practice patterns and preferences in clinical areas of contention, such as initiation dosing, obesity, and renal impairment. Objective: To determine pharmacist trends in practice regarding DOACs for the treatment of VTE overall and within areas of clinical controversy. Methods: An electronic survey was distributed to pharmacists in the United States through national and state pharmacy organizations...

In recent years, anticoagulant and antiplatelet use have increased over the past years for the prevention and treatment of several cardiovascular conditions. Due to the rising use of antithrombotic medications and the complexity of specific clinical cases requiring such therapies, bleeding remains the primary concern among patients using antithrombotics. Direct oral anticoagulants (DOACs) include rivaroxaban, apixaban, edoxaban, and betrixaban. Direct thrombin inhibitors (DTIs) include argatroban, bivalirudin, and dabigatran...

BACKGROUND Comorbidities and polypharmacy are difficult to manage, as polypharmacy hinders identification and prevention of medication-related problems. Risk for adverse drug events (ADEs) can be minimized through pharmacogenomic (PGx) testing and related therapeutic adjustments. CASE REPORT A 70-year-old woman with comorbidities and medications enrolled in the Program of All-inclusive Care for the Elderly presented with left lower extremity (LLE) pain, generalized weakness, and major depressive disorder. The provider requested a medication safety review, where the clinical pharmacist-recommended PGx testing given the LLE pain and weakness while taking a statin and inconsistent INR readings taking warfarin...

Background Apixaban is a direct-acting oral anticoagulant (DOAC) used to treat or prevent thromboembolic events. Renal impairment limits DOAC use. Studies supporting Food and Drug Administration (FDA)-approval for apixaban did not include patients with a creatinine clearance < 25 mL/min. Consequently, limited guidance for use in end-stage renal disease (ESRD) exists in the package insert. An in-depth literature search reveals substantial evidence supporting the safety and effectiveness of apixaban in ESRD...

Background and objectives : We aimed to describe medication-related incidents or medication errors (MEs) reported by community pharmacists and analyze the prevalent medications involved. Materials and Methods : We extracted ME reports from databases comprising patient safety incidents reported to the Korean Pharmaceutical Association between January 2013 and June 2021. Medications were analyzed according to the second (therapeutic subgroup) and fifth (chemical substance) levels of the Anatomical Therapeutic Chemical classification...

BACKGROUND: Atrial fibrillation (AF) negatively impacts health systems worldwide. We aimed to capture perceptions of and barriers and facilitators for AF care in Brazilian primary care units (PCUs) from the perspective of healthcare professionals (HCPs). METHODS: This mixed-methods, cross-sectional study utilised an exploratory sequential design, beginning with the quantitative data collection (up to 18 closed questions) immediately followed by a semi-structured interview...

DISCLAIMER: In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. PURPOSE: Direct oral anticoagulant (DOAC) medications have improved safety, efficacy, and laboratory monitoring requirements compared to warfarin...

Background and Objective: The role of pharmacists in society is unique since they are providers of drug information and medication counseling to patients. Hence, the present study was designed to investigate the knowledge, of undergraduate pharmacy students regarding food drug (FDIs) and alcohol-drug interactions (ADIs) at King Saud University, Riyadh Saudi Arabia. Methodology: An online cross-sectional study was conducted among undergraduate pharmacy students at King Saud University, Riyadh, Saudi Arabia from October 2021 to January 2022, using self-administered 24-items questionnaires focused on evaluating the knowledge of FDIs and ADIs...

Purpose: To assess the impact of a pharmacist-led warfarin to DOAC conversion initiative during the COVID-19 pandemic. Methods: Patients who were prescribed warfarin and followed with the anticoagulation clinic for INR monitoring were assessed by outpatient clinical pharmacists as potential candidates for transition to DOACs from March-August 2020. Results: 530 patients were assessed for transition to DOACs, of which 373 (70.4%) were deemed by clinical pharmacists to be candidates for DOACs. Of the patients who were candidates for DOACs, 66 (17...

BACKGROUND: This systematic overview was commissioned by England's Department of Health and Social Care (DHSC) to assess the evidence on direct (previously 'novel') oral anticoagulants (OACs), compared with usual care, in adults, to prevent stroke related to atrial fibrillation (AF), and to prevent and treat venous thromboembolism (VTE). Specifically, to assess efficacy and safety, genotyping, self-monitoring, and patient and clinician experiences of OACs. METHODS: We searched MEDLINE, Embase, ASSIA, and CINAHL, in October, 2017, updated in November 2021...

INTRODUCTION: Pharmacovigilance (PV) has proven to detect post-marketing adverse drug events (ADE). Previous research used the natural language processing (NLP) tool to extract unstructured texts relevant to ADEs. However, texts without context reduce the efficiency of such algorithms. Our objective was to develop and validate an innovative NLP tool, aTarantula, using a context-aware machine-learning algorithm to detect existing ADEs from social media using an aggregated lexicon. METHOD: aTarantula utilized FastText embeddings and an aggregated lexicon to extract contextual data from three patient forums (i...

Drug-related problems (DRPs) in a pharmacist-managed anticoagulation clinic (AC) have not been extensively studied. We aimed to characterize the DRPs in a pharmacist-managed AC, identify the factors associated with the solved status of DRPs, and analyze the secondary outcomes, including the safety and efficacy of AC service. The patients receiving services at a pharmacist-managed AC in a medical center for the first time from March 2019 to August 2020 were reviewed retrospectively. The DRPs were retrieved from a self-developed Intelligent AC Service System and classified according to the Pharmaceutical Care Network Europe Foundation v9...

Background: Despite warfarin therapy had been used for decades for patients with mechanical mitral valve prostheses (MMVPs), serious and life-threatening complications are still reported worldwide with a significant economic burden. This study is aimed at assessing the clinical and the cost-effectiveness of adopting pharmacist-managed warfarin therapy (PMWT) services for optimizing warfarin treatment in Egypt. Methods: A prospective randomized trial in which 59 patients with MMVPs were randomly assigned to receive the PMWT services or the standard care and followed up for 1 year...

INTRODUCTION: Patients taking warfarin require frequent international normalized ratio (INR) monitoring in healthcare settings, putting them at increased risk of Coronavirus disease 2019 (COVID-19) exposure during the pandemic. Thus, strategies to limit in-person visits to healthcare facilities were recommended by the Anticoagulation Forum. The objective of this study was to describe the number and types of changes made to anticoagulation therapy as a result of pharmacist intervention during the COVID-19 pandemic...

Warfarin and rivaroxaban were the two most commonly-used anticoagulant drugs for Deep venous thrombosis (DVT). The aim of this study was to explore the effects of post-discharge pharmacist-led follow-up on drug treatment in patients with DVT in primary hospitals from a pharmacological perspective. A total of 125 patients were recruited from July 2017 to June 2019 and randomized to either a control group or an intervention group. The control group was given routine medication guidance, clinical pharmacists followed up at 3 and 6 months after discharge...

BACKGROUND: Vitamin K antagonists, such as warfarin, are the most prescribed anticoagulation medication for the treatment of non-valvular atrial fibrillation (NVAF). The prevalence of NVAF ranges from 0·5% to 1·0% in the general population. We investigated compliance with warfarin treatment among patients with NVAF in Gaza Strip. METHODS: This was a cross-sectional study done from January, 2017, to October, 2017, at the Indonesian Hospital, Gaza Strip, occupied Palestinian territory...

BACKGROUND: Elderly patients with atrial fibrillation (AF) are increasingly offered direct oral anticoagulants (DOACs) to reduce the risk of catastrophic stroke but still require clinical follow-up and compliance check to maintain patient safety. Although a recent qualitative meta-analysis has explored up to date research in this area,1 little is known qualitatively, in the United Kingdom, about clinicians' or patients' views and experiences of DOAC use in primary care. AIM: To understand the experiences of healthcare practitioners and patients in relation to DOAC use in primary care...

Introduction: Drug-drug interaction (DDI) is one of the major healthcare challenges in intensive care units (ICUs). The prevalence of DDIs and interacting drug pairs may vary between different types of ICUs. This study aimed to compare the frequency and nature of important and well-documented potential DDIs (pDDIs) in three types of ICUs. Materials and methods: A prospective study was conducted in medical (M), surgical (S), and emergency (E) ICUs of a tertiary referral center for respiratory diseases...

Objective: To evaluate the impact of pharmacist interventions on international normalized ratio (INR) control during the warfarin initiation phase after mechanical valve replacement. Methods: This was a retrospective cohort study conducted in a cardiovascular surgery ward in a tertiary hospital from August 1, 2015, to July 31, 2019. Patients aged ≥20 years who were admitted for mechanical valve replacement were enrolled in this study and further classified into conventional and pharmacist-managed warfarin therapy (PMWT) groups...