Ahmed Nahid Osman, Osman Bashier, Abdelhai Yassein Mohamed, El-Hadiyah Tariq Muhammed Hashim
Department of Pharmacy Practice, Faculty of Pharmacy, Qassim University, Al-Malida, Kingdom of Saudi Arabia.
Department of Pharmacology, Faculty of Pharmacy, University of Khartoum, P.O. Box 1996, Khartoum, Sudan.
Int J Clin Pharm. 2017 Aug;39(4):769-773. doi: 10.1007/s11096-017-0475-x. Epub 2017 May 15.
Background Many trials have compared anticoagulation management provided by a pharmacist led anticoagulation clinic versus usual physician care showing the role for clinical pharmacist in the management of anticoagulant therapy, and demonstrating excellent outcomes. In Sudan, there is no published research evaluating the role of pharmacist in providing pharmaceutical care for patients taking warfarin. Objective The objective of the study is to assess the role of clinical pharmacist intervention in warfarin patients compared to usual medical care. Setting This study was conducted in Ahmed Gasim cardiac surgery and renal transplant center warfarin clinic. Methods One hundred thirty-five patients were randomly selected from adult patients on warfarin therapy The history of INR records, and adverse effects for the past year, were recorded. Then patients' warfarin dose adjustments according to INR, was done by the clinical pharmacist for one year. Patients received continuous verbal education and written information about warfarin. Main outcome measure The primary outcome for this study was the INR control, while the secondary outcomes were the bleeding events and hospitalization due to warfarin. Results After the clinical pharmacist intervention there was significant (P < 0.01) improvement in INR control and a significant (P < 0.05) reduction in incidence of bleeding after clinical pharmacist intervention. Hospitalization due to warfarin related complications (bleeding, high INR, low INR) was also significantly (P < 0.001) reduced. Conclusion Clinical pharmacists intervention in warfarin therapy improve INR control, reduce bleeding and hospitalization due to warfarin complications.
许多试验比较了由药剂师主导的抗凝门诊提供的抗凝管理与常规医生护理，显示了临床药剂师在抗凝治疗管理中的作用，并证明了良好的效果。在苏丹，尚无发表的研究评估药剂师在为服用华法林的患者提供药学服务方面的作用。
本研究的目的是评估与常规医疗护理相比，临床药剂师干预对华法林患者的作用。
本研究在艾哈迈德·加西姆心脏外科和肾移植中心华法林门诊进行。
从接受华法林治疗的成年患者中随机选取135例患者，记录其国际标准化比值（INR）记录历史以及过去一年的不良反应。然后由临床药剂师根据INR对患者的华法林剂量进行调整，为期一年。患者接受了关于华法林的持续口头教育和书面信息。
本研究的主要结局指标是INR控制，次要结局指标是出血事件和因华法林导致的住院情况。
临床药剂师干预后，INR控制有显著改善（P < 0.01），临床药剂师干预后出血发生率显著降低（P < 0.05）。因华法林相关并发症（出血、INR过高、INR过低）导致的住院情况也显著减少（P < 0.001）。
临床药剂师对华法林治疗的干预可改善INR控制，减少因华法林并发症导致的出血和住院情况。
