Outcomes of Pharmaceutical Care in Anticoagulation Clinic at Roi-Et Hospital, Roi-Et Province, Northeastern Thailand
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2010-02-15
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Journal of Science and Technology Mahasarakham University - วารสารวิทยาศาสตร์และเทคโนโลยี มหาวิทยาลัยมหาสารคาม
Abstract
The objectives of this study were to compare before and after pharmaceutical care in patient’s INR, knowledge scores about disease, warfarin treatment and correction of self-management while using warfarin, number and type of warfarin-related problems. Patients who were treated with warfarin and got service in the anticoagulation clinic at Roi-Et Hospital during January 9 to April 12, 2006 were recruited. This study was a before and after experimental study with no control group. Primarily, 60 patients were included but one was excluded because of irregular attendance at treatment follow up. Among 59 patients, 39 were women (66.1%) and 20 were men (33.9%). Their average age was 51.1 ± 10.7 years old. Most patients either before or after pharmaceutical care had INR lower than the target INR (69.5% and 47.5%, respectively). The number of patients who had INR lower than the target INR was significantly decreased than before pharmaceutical care (p \< 0.001). The average knowledge scores about disease, warfarin treatment and correction of self-management while using warfarin before and after pharmaceutical care were 6.58 ± 1.62 and 9.80 ± 1.30, respectively. There was a significant increase in the average score after pharmaceutical care (p \< 0.001). Warfarin-related problems before pharmaceutical care were 70 in 43 patients (72.9%). The most common types of problem were non-compliance (27.2%), subtherapeutic dosage (25.7%), and bleeding (21.4%). After pharmaceutical care, there were 20 problems in 16 patients (27.1%). The type of these problems included subtherapeutic dosage (35.0%), drug-drug interaction (35.0%), and bleeding (30.0%). The number of warfarin-related problems was significantly decreased after pharmaceutical care (p \< 0.001). Therefore, the drug counseling and pharmaceutical care by pharmacists for patient who used medication could help reduce drug-related problems, increase knowledge, understand warfarin therapy and correct self-management that would lead to increase the effectiveness of therapy and patients’ quality of life.
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Journal of Science and Technology Mahasarakham University - วารสารวิทยาศาสตร์และเทคโนโลยี มหาวิทยาลัยมหาสารคาม; Volume 27 Number 1 January-March 2008; 59-67