Exploring the role for Pharmacists in Perioperative Anticoagulation Management
Blow, Sophie E.
Blow, Sophie E.
Publication Date
End of Embargo
Supervisor
Silcock, Jonathan
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The University of Bradford theses are licenced under a Creative Commons Licence.
Peer-Reviewed
Open Access status
Accepted for publication
Institution
University of Bradford
Department
School of Pharmacy. Faculty of Life Sciences
Awarded
2023
Embargo end date
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Abstract
Introduction: There are currently no national guidelines on the perioperative management of anticoagulants. The perioperative management of anticoagulants by pharmacists has not been explored.
Aim: This study aims to explore the role of a pharmacist providing perioperative anticoagulation management advice.
Method: A small-scale, first-wave study was performed in a large, UK teaching hospital. Data was obtained from three years of pharmacist delivered perioperative anticoagulation optimisation clinics. The intervention included provision by a pharmacist of a personalised perioperative anticoagulation management plan.
Results: Perioperative anticoagulation management advice was provided to 312 patients, 116 patients were provided with a perioperative anticoagulation management plan and 86 patients completed the study. The control group consisted of 144 patients. In the intervention group, the provision of the perioperative anticoagulation management plan resulted in a higher incidence of a preoperative INR check with 77% completion versus 61% in the control group (p<0.01). The number of days with subtherapeutic anticoagulation postoperatively was reduced by five days in the intervention group (p<0.01). There were also fewer postoperative INR checks performed, 3 checks (median) in the control group compared to 2 checks in the study intervention group (p<0.01). The study intervention group required significantly (p<0.01) fewer postoperative warfarin booster doses than the control group, 9% versus 76% respectively.
Conclusion: The study demonstrated that the perioperative management of anticoagulants by a specialist pharmacist improved patient outcomes. Further research is needed to confirm the findings of this study using a larger scale trial with randomisation.
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Type
Thesis
Qualification name
PharmD