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Title AN EVALUATION OF THE PHARMACISTS-LED ANTICOAGULATION CLINIC IN ACHIEVING TIME TO THERAPEUTIC RANGE (TTR) AT CHANGI GENERAL HOSPITAL |
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Type Free Paper Session 5 |
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Theme ACC Asia & SCS 32nd Annual Scientific Meeting |
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Topic Basic Science |
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Main Author Hui Bing Chuah1 |
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Presenting Author Hui Bing Chuah1 |
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Co-Author Daniel Fletcher1 Kelvin Wong2 |
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Department / Institution / Country Pharmacy / Changi General Hospital / Singapore1 Cardiology / Changi General Hospital / Singapore2 |
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Objective(s) To determine the percentage of time to therapeutic range (TTR) of ACC managed patients’ International Normalised Ratio (INR) compared with those managed by physicians. |
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Material and Method This is a retrospective observational cohort study done in CGH outpatient settings. INR of AF patients on warfarin from 1st January 2015 till 31st December 2016 were extracted and divided according to care groups (ACC led and physician led). Based on the inclusion and exclusion criteria, there were 40 patients in the ACC group and 38 patients in the physician group). Statistical Package for Social Sciences (SPSS) v.21.0. was used for data analysis. Independent t-test was used to analysed the TTR between the two groups. INR values <1.5 and > 5.0 for both groups were also tabulated. |
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Result(s) Patients from the ACC group had a TTR 55% of the time compared with 53% in the physician group. There was no significant difference in mean TTR (mean difference -1.38%, 95% CI -10.6% to 7.83%; p = 0.766). During the two year titration period, 200 INR values in the ACC group were< 1.5 compared to 140 INR values in the physicians' group (5.38% vs 3.76%). For INR >5.0, there were 8 INR values from the physicians' group and 4 values from the ACC group that exhibit this (0.22% vs 0.11%). |
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Conclusion The effectiveness ACC managed cases were identical to the physicians postulating that the management is comparable. There was a lesser incidence of supratherapeutic INR in the ACC group compared with the physician group. |