| This project investigates the impact of a pharmacist delivered anticoagulant management service. In a controlled trial, patients receiving warfarin will be recruited through their general practitioner and pharmacist and will be allocated to either a warfarin management service by a community pharmacist or to “usual” management. The main outcomes over the study period of 12 months will be stability of patient’s blood clotting status and episodes of excessive bleeding. Humanistic and economic outcomes will also be assessed. Pharmacists will be trained to provide patient education and to use portable INR monitors to assess clotting status. Pharmacists will monitor INR and make dosage recommendations when needed to maintain a patients’ INR within the target range. Results and pharmacist’s recommendations will be communicated to the patient’s general practitioner for vetting and/or discussion. The cost-effectiveness of a pharmacist based anticoagulant management service will be studied and funding models for implementation in pharmacy will be proposed. |
