Efficacy of protocol-based pharmacotherapy management on anticoagulation with warfarin for patients with cardiovascular surgery

• DOI: 10.1111/jcpt.12560
• Publication Date: 2017-05-15T05:56:49Z
• Authors: Y. Katada; S. Nakagawa; K. Minakata; M. Odaka; H. Taue; Y. Sato; A. Yonezawa; Y. Kayano; I. Yano; T. Nakatsu; K. Sakamoto; K. Uehara; H. Sakaguchi; K. Yamazaki; K. Minatoya; R. Sakata; K. Matsubara
• Keywords: Pharmacotherapy; Prothrombin time

What is known and objective Anticoagulation therapy with warfarin requires periodic monitoring of prothrombin time-international normalized ratio (PT-INR) adequate dose adjustments based on the data to minimize risk bleeding thromboembolic events. In our hospital, we have developed protocol-based pharmaceutical care, which called pharmacotherapy management (PBPM), for therapy. The protocol pharmacists manage timing blood sampling measuring PT-INR dosage determination an algorithm. This study evaluated efficacy PBPM in by comparing conventional care. METHODS From October 2013 June 2015, a total 134 hospitalized patients who underwent cardiovascular surgeries received post-operative early series as care (control group, n=77), whereas latter (PBPM n=68). These formed cohort present were retrospectively analysed. RESULTS indications included aortic valve replacement (n=56), mitral (n=4), plasty (n=22) atrial fibrillation (n=29). There no differences patients' characteristics between both groups. percentage time therapeutic range first 10 days was significantly higher group (47.1%) than that control (34.4%, P<.005). average reach steady state (P<.005) shorter compared (7.3 vs 8.6 days). new conclusion Warfarin novel clinically safe resulted better anticoagulation