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Improving the outcomes of anticoagulation in rural Australia: An evaluation of pharmacist-assisted monitoring of warfarin therapy


Jackson, SL and Peterson, GM and Bereznicki, LRE and Misan, GM and Jupe, DML and Vial, JH, Improving the outcomes of anticoagulation in rural Australia: An evaluation of pharmacist-assisted monitoring of warfarin therapy, Journal of Clinical Pharmacy and Therapeutics, 30, (4) pp. 345-353. ISSN 0269-4727 (2005) [Refereed Article]

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DOI: doi:10.1111/j.1365-2710.2005.00656.x


Objective: The aim of this project was to assess whether rural pharmacist involvement in the management of patients receiving warfarin has the potential to lead to safer and more effective anticoagulation, and is valued and welcomed by patients and their general practitioners (GPs).

Methods: A convenience sample of rural pharmacists was trained in the use of the CoaguChek S International Normalized Ratio (INR) monitor and then conducted pharmacy-based testing for approximately 3 months. Two types of testing were performed in the pharmacy: (i) comparison testing was defined as pharmacy-based tests taken within 4 h of conventional laboratory testing or (ii) additional testing, which was a pharmacy-based test with no direct comparison laboratory test taken. Pharmacists, GPs and patients completed anonymous satisfaction surveys after the completion of the pharmacy-based testing.

Results: Pharmacists from 16 rural pharmacies were trained to use the CoaguChek S monitor. During the trial period, 518 INR tests were performed in the pharmacies on 137 different patients. A total of 120 tests were evaluated against results from laboratory testing. The pharmacy-based INR values were significantly correlated with the laboratory INR values (mean of 232 077 and 232 059 respectively; r = 088, P < 00001). A total of 398 additional pharmacy-based tests were conducted in the pharmacy and 85% of the additional tests resulted in a subsequent dosage change. The monitoring was well received by pharmacists, GPs and patients.

Conclusions: The results of the trial were very positive. The CoaguChek S monitor in pharmacy-based testing performed accurately compared with conventional laboratory testing. Further research needs to be conducted on the impact of community pharmacy-conducted INR monitoring on patient care and outcomes.

Item Details

Item Type:Refereed Article
Keywords:anticoagulation, International Normalized Ratio, monitoring, pharmacy, point-of-care, rural, warfarin
Research Division:Biomedical and Clinical Sciences
Research Group:Pharmacology and pharmaceutical sciences
Research Field:Pharmaceutical sciences
Objective Division:Health
Objective Group:Specific population health (excl. Indigenous health)
Objective Field:Rural and remote area health
UTAS Author:Jackson, SL (Dr Shane Jackson)
UTAS Author:Peterson, GM (Professor Gregory Peterson)
UTAS Author:Bereznicki, LRE (Professor Luke Bereznicki)
UTAS Author:Jupe, DML (Dr David Jupe)
UTAS Author:Vial, JH (Associate Professor Janet Vial)
ID Code:33248
Year Published:2005
Web of Science® Times Cited:27
Deposited By:Pharmacy
Deposited On:2005-08-01
Last Modified:2013-03-20
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