Anticoagulation management is a challenge for the healthcare providers including clinicians due to its narrow safety margin with either bleeding or clot formation beyond its therapeutic range. Periodic monitoring of INR levels and identification of risk factors have a major role in oral anticoagulation therapy and hence close monitoring of patients is a must. The purpose of this study was to analyse the impact of clinical pharmacist initiated interventions in anticoagulation management in a selected tertiary care hospital. Prospective interventional study was conducted using retrospective data of the patients as control. Patients in intervention group received care from the clinical pharmacists in addition to the routine care by clinicians and other healthcare providers. Out of 51 patients enrolled in the study, 41 patients were same in retrospective and prospective arm. There was a statistically significant improvement in knowledge score of patients in the intervention group when compared with control group (p<0.01). A significant improvement in medication adherence of patients between control group and interventional group (p<0.01) was also observed. Knowledge about the anticoagulation therapy and medication adherence to treatment has a significant role in anticoagulation management as there was improvement in time on target INR range in the intervention arm compared to control arm. The therapeutic outcome of treatment improved in this study as the percentage of patients on target INR range increased from baseline. Qualified clinical pharmacist can thereby play an important role in anticoagulation management by imparting knowledge to the patients on the same.
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