Pharmacy OneSource Blog

Clinical Corner: Measuring Clinical Impact of Your Inpatient Anticoagulation Program – What Are You Doing?

Posted on 12/04/13


Pharmacy is a discipline that can have a dramatic effect on patient care but that impact is not always measured or reported. When it comes to anticoagulant medications, pharmacist-driven programs can help improve anticoagulation safety, as seen in Pharmacy Practice News.

Anticoagulants remain in the top 10 list of medication classes that are responsible for medication errors. Many hospitalized patients are either admitted on or are started on warfarin. How can pharmacists be aware of complications that may occur with anticoagulants?

Research by Victor Tapson, et. al reviewed antithrombotic therapy data at 38 hospitals. The researchers looked at 1,749 patients who received warfarin at any time during hospitalization and found:

  • 157 (9.0%) had at least 1 INR value greater than 4.0
  • 120 (6.9%) experienced minor hemorrhage (hematoma, microscopic hematuria, epistaxis, or ecchymosis)
  • 65 (3.7%) were administered phytonadione
  • 14 (0.8%) experienced major hemorrhage
If you have a system that will enable you to easily create reports, try looking at some of the following data to measure the impact of your clinical pharmacy services:
  • Find the number of patients taking warfarin
  • Percentage of patients on warfarin for at least 3 days that do not have an INR in the range of 2-3
  • Percentage of patients on warfarin who have an INR > 6
  • Percentage of patients on warfarin without a daily INR
  • Percentage of patients educated
  • Percentage of patients on warfarin with hematuria or other signs of bleeding
  • Percentage of patients on warfarin that received vitamin K

Do you currently collect any of these statistics? If so, how do you compare to the rates in the published article?

Implementation of Risk Evaluation and Mitigation Strategy Programs in a Health System

Topics: Clinical Pharmacy

About the Author

Janet Blackmere, PharmD is a Pharmacy Clinical Program Manager for Pharmacy OneSource. Janet has more than 15 years of experience in pharmacy informatics, pharmacy workflow optimization, automation and clinical decision support. She also has 10 years of consulting experience. She is a member of American Society of Health-System Pharmacists (ASHP) and the Florida Society of Health-System Pharmacists (FSHP). Janet received her PharmD from the University of Florida and completed a specialty Residency in Computer Applications to foster Pharmaceutical Care.