Anticoagulation management by physician-clinical pharmacist team for patients with valvular atrial fibrillation
10.3760/cma.j.issn.1671-7368.2018.12.009
- VernacularTitle:医师-临床药师协作抗凝管理服务在瓣膜病型心房颤动患者中的应用
- Author:
Wenqi LIU
1
;
Jie LIU
;
Zhengrong LI
;
Fengyuan CHE
;
Zonglin ZHANG
;
Zengcheng SHI
;
Zhihong OU
Author Information
1. 276003,山东省临沂市人民医院药学部
- Keywords:
Atrial fibrillation;
Warfarin;
Anticoagulation management service;
Physician;
Clinical pharmacist;
International normalized ratio
- From:
Chinese Journal of General Practitioners
2018;17(12):997-1001
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the effectiveness of anticoagulation management by physician-clinical pharmacist team for patients with valvular atrial fibrillation. Methods One hundred and seventy two patients with valvular atrial fibrillation received warfarin therapy for anticoagulation during hospitalization in Linyi People′s Hospital from January 2014 to December 2016, the patients continued to receive warfarin therapy for>6 months after discharge. The patients were randomly assigned in two groups:the anticoagulation management was given by physician-clinical pharmacist team in 87 cases (trial group), while the dosage of wargarin was adjusted in outpatient department by physicians alone in 85 cases (control group). The goal attainment rate of international normalized ratio (INR), the proportion of patients with a stable warfarin dose, knowledge of anticoagulants, belief of medication, medication compliance were compared between two groups. Results There were no significant differences in age, sex, body weight, smoking and drinking habits, valvular disease type, comorbidities; and the initial INR, knowledge of anticoagulants, belief of medication and medication compliance at admission between two groups (all P>0.05). The goal attainment rate of INR (52.17％vs. 41.02％,χ2=8.178, P=0.004), the proportion of patients with a stable dose of warfarin (74.71％ vs. 56.47％,χ2=6.349, P=0.012), the knowledge of anticoagulants (11.03 ± 2.25 vs. 10.08 ± 1.86, t=3.018, P=0.003), the belief of medication[(12.23 ± 2.07) vs. (11.67 ± 1.48), t=2.042, P=0.043], and the medication compliance[(7.36 ± 0.89) vs. (7.04 ± 1.10), t=2.1128, P=0.036] in the trial group were significantly higher than those in control group. Conclusion Anticoagulation management by physician - clinical pharmacist team can improve the management level of anticoagulation and the knowledge of anticoagulans, enhance the medication belief, improve the goal attainment rate of INR and the compliance rate of medication in patients with valvular atrial fibrillation.
