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KMID : 0869620110280020111
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Journal of Korean Society of Hospital Pharmacists
2011 Volume.28 No. 2 p.111 ~ p.117
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Outcomes of Anticoagulation Service Monitored by Telephone vs. In-office visits
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Moon Mi-Ra
Kim A-Jeong
Lee Yong-Hwa
Han Hyun-Joo
Son In-Ja
Lee Hye-Sook
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Abstract
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Background : Anticoagulation service(ACS) provided by pharmacist offers safe and effective use of warfarin. In Seoul National University Hospital, clinical pharmacists run telephone-based and traditional office-based ACS. There are no studies about effectiveness of the different ways of ACS for Korean patients. The objective of this study was to compare warfarin-related monitoring outcomes and complications in anticoagulation clinic patients whose management was conducted by telephone or in-office based visits. Moreover, we conducted a survey about patients’ satisfaction for two kinds of services.
Methods : A total 388 patients were enrolled; 194 patients managed by telephone were compared to 194 patients managed in office-based visits. Retrospective methods were used to evaluate clinical outcomes such as time in therapeutic INR values and complication episodes. Patient satisfaction was assessed using 5-point scale.
Results : Slightly high percentage of therapeutic INR values was found in office visits group (82% vs. 76%, p=0.04). Bleeding events were more frequently occurred in office visits group (64 vs. 44, p=0.03). However major bleeding events were similar between groups (5 vs. 6, p=0.83). No thromboembolic event was found. In aspect of patient satisfaction, same score was recorded between two groups (4.7 point).
Conclusion : Traditional office-based ACS provided proper therapeutic INR values. To secure clinical outcomes of telephone-based ACS, further investigations are required.
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KEYWORD
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anticoagulation service, telephone management, patients’ satisfaction
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