JOURNAL OF ASIAN ASSOCIATION OF SCHOOLS OF PHARMACY - Volume 11, January - December 2022

Pages: 22-29
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Impact of pharmacist-led anticoagulation clinic on anticoagulation control and clinical outcomes of warfarin-treated patients with atrial fibrillation: A retrospective study in Hong Kong

Author: Tsoi-Man Chung , Max Mak, Joyce Ng, Tracy Wong, Belinda Wong, Catherine Chan, Ka-Fai Lee, Joyce H.S. You

Category: Pharmacy

Abstract:

Kwong Wah Hospital (KWH), a Hong Kong public hospital has introduced pharmacist-led anticoagulation clinic (PAC) for warfarin management. We aimed to evaluate the PAC impact on anticoagulation control and clinical outcome in patients with atrial fibrillation (AF). This was a single-centered observational retrospective study including 148 warfarintreated AF patients over 2-year period. Time-in-therapeutic range (TTR) improved from 61.4 ± 29.4% (1-year prior to PAC) to 71.3 ± 18.9% (1-year after joining PAC) (p < 0.001; paired Student’s t-test). There were 17 bleeding and 2 stroke events during study period. No significant difference in event incidence was observed between the two periods. Patients were divided into good (TTR <60%) and poor anticoagulation control (TTR <60%) group to determine possible predictors for poor anticoagulation control. Hypertension (OR = 0.37, 95%CI = 0.168–0.814, p = 0.013) and older age >= 75 (OR = 0.286, 95%CI = 0.112–0.732, p = 0.009) showed inversely association as predictor of poor anticoagulation in multivariate regression. In conclusion, PAC demonstrated improved warfarin anticoagulation quality in AF patients at KWH in Hong Kong.

Keywords: pharmacist, anticoagulation clinic, warfarin, Hong Kong