Tele-pharmacy Anticoagulation Clinic During COVID-19 Pandemic: Patient Outcomes

Introduction: It is well-established that clinical pharmacist-managed anticoagulation services achieve superior anticoagulation control, with a positive impact. At King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia, the structure of anticoagulation management is a pharmacist-managed specialty...

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Autores principales: Al Ammari, Maha, AlThiab, Khalefa, AlJohani, Manal, Sultana, Khizra, Maklhafi, Nada, AlOnazi, Hayel, Maringa, Aswaq
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8459665/
https://www.ncbi.nlm.nih.gov/pubmed/34566632
http://dx.doi.org/10.3389/fphar.2021.652482
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author Al Ammari, Maha
AlThiab, Khalefa
AlJohani, Manal
Sultana, Khizra
Maklhafi, Nada
AlOnazi, Hayel
Maringa, Aswaq
author_facet Al Ammari, Maha
AlThiab, Khalefa
AlJohani, Manal
Sultana, Khizra
Maklhafi, Nada
AlOnazi, Hayel
Maringa, Aswaq
author_sort Al Ammari, Maha
collection PubMed
description Introduction: It is well-established that clinical pharmacist-managed anticoagulation services achieve superior anticoagulation control, with a positive impact. At King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia, the structure of anticoagulation management is a pharmacist-managed specialty service. With the current COVID-19 situation, measures were taken to assure the continuity of patient care by establishing tele-pharmacy anticoagulation clinics. Materials and Methods: This was a prospective study with patients prescribed anticoagulation and followed up for 3 months. Since establishing the anticoagulation virtual clinic in March 2020, 270 patients were recruited in the study. The data collected included age, gender, comorbidities, indication for anticoagulation, intended duration of treatment, warfarin dose, testing of International Normalized Ratio (INR), INR target, range of INR values, time INR that was within the therapeutic range (TTR), and complications of therapy (bleeding and/or bruises). The patients were asked to complete the pharmacist satisfaction survey (PSS) after their consultation to assess patient satisfaction with the new virtual consultation system. Linguistic and cultural validation was conducted for the questionnaire. Results: A total of 270 patients were included in the study. The mean percentage of overall INR values in the range was 59.39% ± 32.84, and the mean time with the overall INR was within the therapeutic range 57.81% ± 32.08. Thirty-one percent of the sample had good anticoagulation control (time in therapeutic range >70%). The median satisfaction score was 32 (IQR 28–36) with a maximum score of 40. Conclusion: This is the first study to assess the tele-pharmacy anticoagulation clinic’s efficiency and patient satisfaction in Saudi Arabia during the COVID-19 pandemic. This type of consultation was as effective as face-to-face consultations. The study also highlighted that though the reduction in the cost of care was not substantial, there was a significant increase in resource (clinical pharmacist) utilization as a result of this model. The adoption of tele-pharmacy resulted in time savings for the clinical pharmacists who can be utilized in many other improvement projects in adult ambulatory clinics to ensure the delivery of better quality and safe patient care.
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spelling pubmed-84596652021-09-24 Tele-pharmacy Anticoagulation Clinic During COVID-19 Pandemic: Patient Outcomes Al Ammari, Maha AlThiab, Khalefa AlJohani, Manal Sultana, Khizra Maklhafi, Nada AlOnazi, Hayel Maringa, Aswaq Front Pharmacol Pharmacology Introduction: It is well-established that clinical pharmacist-managed anticoagulation services achieve superior anticoagulation control, with a positive impact. At King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia, the structure of anticoagulation management is a pharmacist-managed specialty service. With the current COVID-19 situation, measures were taken to assure the continuity of patient care by establishing tele-pharmacy anticoagulation clinics. Materials and Methods: This was a prospective study with patients prescribed anticoagulation and followed up for 3 months. Since establishing the anticoagulation virtual clinic in March 2020, 270 patients were recruited in the study. The data collected included age, gender, comorbidities, indication for anticoagulation, intended duration of treatment, warfarin dose, testing of International Normalized Ratio (INR), INR target, range of INR values, time INR that was within the therapeutic range (TTR), and complications of therapy (bleeding and/or bruises). The patients were asked to complete the pharmacist satisfaction survey (PSS) after their consultation to assess patient satisfaction with the new virtual consultation system. Linguistic and cultural validation was conducted for the questionnaire. Results: A total of 270 patients were included in the study. The mean percentage of overall INR values in the range was 59.39% ± 32.84, and the mean time with the overall INR was within the therapeutic range 57.81% ± 32.08. Thirty-one percent of the sample had good anticoagulation control (time in therapeutic range >70%). The median satisfaction score was 32 (IQR 28–36) with a maximum score of 40. Conclusion: This is the first study to assess the tele-pharmacy anticoagulation clinic’s efficiency and patient satisfaction in Saudi Arabia during the COVID-19 pandemic. This type of consultation was as effective as face-to-face consultations. The study also highlighted that though the reduction in the cost of care was not substantial, there was a significant increase in resource (clinical pharmacist) utilization as a result of this model. The adoption of tele-pharmacy resulted in time savings for the clinical pharmacists who can be utilized in many other improvement projects in adult ambulatory clinics to ensure the delivery of better quality and safe patient care. Frontiers Media S.A. 2021-09-09 /pmc/articles/PMC8459665/ /pubmed/34566632 http://dx.doi.org/10.3389/fphar.2021.652482 Text en Copyright © 2021 Al Ammari, AlThiab, AlJohani, Sultana, Maklhafi, AlOnazi and Maringa. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pharmacology
Al Ammari, Maha
AlThiab, Khalefa
AlJohani, Manal
Sultana, Khizra
Maklhafi, Nada
AlOnazi, Hayel
Maringa, Aswaq
Tele-pharmacy Anticoagulation Clinic During COVID-19 Pandemic: Patient Outcomes
title Tele-pharmacy Anticoagulation Clinic During COVID-19 Pandemic: Patient Outcomes
title_full Tele-pharmacy Anticoagulation Clinic During COVID-19 Pandemic: Patient Outcomes
title_fullStr Tele-pharmacy Anticoagulation Clinic During COVID-19 Pandemic: Patient Outcomes
title_full_unstemmed Tele-pharmacy Anticoagulation Clinic During COVID-19 Pandemic: Patient Outcomes
title_short Tele-pharmacy Anticoagulation Clinic During COVID-19 Pandemic: Patient Outcomes
title_sort tele-pharmacy anticoagulation clinic during covid-19 pandemic: patient outcomes
topic Pharmacology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8459665/
https://www.ncbi.nlm.nih.gov/pubmed/34566632
http://dx.doi.org/10.3389/fphar.2021.652482
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