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Drug-related problems identified in post-discharge medication reviews for patients taking warfarin

journal contribution
posted on 2023-05-17, 06:12 authored by Leanne ChalmersLeanne Chalmers, Stafford, A, Josephine HughesJosephine Hughes, Angley, M, Luke BereznickiLuke Bereznicki, Gregory PetersonGregory Peterson
Objective To characterise the nature of the drug-related problems with warfarin therapy identified in pharmacist-conducted medication reviews during a collaborative post-discharge warfarin management service, with a focus on potentially serious drug interactions. Setting Australian community pharmacy practice. Method Medication review reports submitted by pharmacists to patients' general practitioners as part of the service were reviewed and the type and clinical significance of the warfarin-associated drug-related problems, and the pharmacists' recommendations were classified. The prevalence of prescribing of 'potentially hazardous' warfarin drug interactions was investigated and compared with the frequency of documentation of these interactions in the medication review reports. Main outcome measure The number and nature of warfarin-associated drug-related problems identified and the rate of documentation of 'potentially hazardous' warfarin drug interactions in the reports from pharmacist-conducted medication reviews. Results A total of 157 warfarin-associated drug-related problems were documented in 109 medication review reports (mean 1.4 per patient, 95% CI 1.3-1.6, range 0-5). Drug selection and Education or information were the most commonly identified warfarin-associated drug-related problems; most drug-related problems were of moderate clinical significance. Eight of 23 potentially serious warfarin drug interactions (34.8%) were identified in the medication review reports. Conclusion Pharmacists addressing drug selection and warfarin education drugrelated problems during medication reviews may have contributed to the positive outcomes of the post-discharge service. Warfarin drug interactions were frequently identified; however, well-recognised potentially hazardous interactions were under-reported. Improved communication along the continuum of care would permit improved targeting of drug-related problem reporting, especially in relation to preventable drug interactions.

Funding

Department of Health and Aged Care

History

Publication title

International Journal of Clinical Pharmacy

Volume

33

Issue

4

Pagination

621-626

ISSN

2210-7703

Department/School

School of Pharmacy and Pharmacology

Publisher

Springer Netherlands

Place of publication

Netherlands

Rights statement

The final publication is available at http://www.springerlink.com

Repository Status

  • Restricted

Socio-economic Objectives

Evaluation of health outcomes

Usage metrics

    University Of Tasmania

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