Management of Warfarin Therapy: A New Point-Of-Care Monitoring Service by Community Pharmacists in India

Objective: To introduce the implementation of point of care INR monitoring service by community pharmacists for optimizing the therapy outcomes of Warfarin, used widely for its anticoagulant activity both as a treatment and prophylaxis. Methods: This prospective, controlled, staggered parallel design study was conducted in selected community pharmacies associated with general practitioners. The patients in the intervention arm received point of care INR measurement and anticoagulant management including assessment of clinical and quality of life endpoints by their pharmacists in collaboration with their general practitioners. Result: 82 patients were recruited into the study in 5 community pharmacies and all these patients were under the medical care of 7 general medical practitioners. About 44 % (n = 36) of the patients recruited into the intervention group submitted their retrospective INR reports which was considered as pre intervention data and used to compare the clinical outcome against post intervention phases. It was found that the patients in the post intervention group had a statistically significant (p < 0.05) control in the INR values than the pre intervention group. A statistically significant difference (p = 0.025) was observed in the quality of life of patients at pre and post intervention groups. There was also a significant (p = 0.016) increase in patient’s knowledge about anticoagulant therapy between pre and post intervention. Conclusion: The community pharmacists and medical practitioners managed anticoagulant service is feasible and acceptable to patients and pharmacist involved in the study.