Department of Pharmacy Practice, School of Pharmacy, Lebanese American University, P.O. Box: 36 (S23), Byblos, Lebanon.
Department of Pharmacy, American University of Beirut Medical Center, P.O.Box: 11 - 0236, Riad El Solh, Beirut, 1107 2020, Lebanon.
BMC Health Serv Res. 2021 Feb 16;21(1):151. doi: 10.1186/s12913-021-06156-2.
There is limited published data in Lebanon evaluating the impact of supplemental education for anticoagulants use, especially DOACs, on clinical outcomes such as bleeding. The study aims to assess the impact of pharmacist-conducted anticoagulation education and follow-up on bleeding and readmission rates.
This study was a randomized, non-blinded interventional study conducted between August 2017 and July 2019 in a tertiary care teaching Lebanese hospital. Participants were inpatients ≥18 years discharged on an oral anticoagulant for treatment. Block randomization was used. The control group received the standard nursing counseling while the intervention group additionally received pharmacy counseling. Phone call follow-ups were done on day 3 and 30 post-discharge. Primary outcomes included readmission rates and any bleeding event at day 3 and 30 post-discharge. Secondary outcomes included documented elements of education in the medical records and reported mortality upon day 30 post-discharge.
Two hundred patients were recruited in the study (100 patients in each study arm) with a mean age of 73.9 years. In the pharmacist-counseled group, more patients contacted their physician within 3 days (14% versus 4%; p = 0.010), received explicit elements of education (p < 0.001) and documentation in the chart was better (p < 0.05). In the standard of care group, patients were more aware of their next physician appointment date (52% versus 31%, p < 0.001). No difference in bleeding rates at day 3 and 30 post-discharge was observed between the groups.
Although pharmacist-conducted anticoagulation education did not appear to reduce bleeding or readmission rates at day 30, pharmacist education significantly increased patient communication with their providers in the early days post-discharge.
Lebanon Clinical Trial Registry LBCTR2020033424 . Retrospectively registered. Date of registration: 06/03/2020.
黎巴嫩发表的关于补充抗凝药物（特别是 DOAC）使用教育对出血等临床结局影响的数据有限。本研究旨在评估药师进行抗凝教育和随访对出血和再入院率的影响。
这是一项 2017 年 8 月至 2019 年 7 月在黎巴嫩一家三级教学医院进行的随机、非盲干预研究。参与者为接受口服抗凝剂治疗出院的年龄≥18 岁的住院患者。采用区组随机化。对照组接受标准护理咨询，而干预组则额外接受药学咨询。出院后第 3 天和第 30 天进行电话随访。主要结局包括出院后第 3 天和第 30 天的再入院率和任何出血事件。次要结局包括病历中记录的教育内容和出院后第 30 天的报告死亡率。
研究共招募了 200 名患者（每组 100 名），平均年龄为 73.9 岁。在药师咨询组中，更多的患者在 3 天内联系了他们的医生（14%比 4%；p=0.010），接受了明确的教育内容（p<0.001），图表记录也更好（p<0.05）。在常规护理组中，患者更清楚他们下次就诊的日期（52%比 31%，p<0.001）。两组出院后第 3 天和第 30 天的出血率无差异。
尽管药师进行的抗凝教育似乎并未降低第 30 天的出血或再入院率，但药师教育显著增加了患者在出院后早期与提供者的沟通。
黎巴嫩临床试验注册处 LBCTR2020033424。回顾性注册。注册日期：2020 年 3 月 6 日。
