The Clinical Outcome Evaluation On The Atrial Fibrillation Patients Receiving Warfarin For Secondary Stroke Prevention In The Medication Therapy Adherence Clinic In Serdang And Seremban Hospitals
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Date
2016-09
Authors
Mochamad Djunaedi
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Abstract
In the Warfarin-Medication Therapy Adherence Clinic (Warfarin-MTAC), pharmacists should play their role in the multidisciplinary health team to improve patients’ adherence in achieving the goal of warfarin therapy. The primary aim of this study is to evaluate the effectiveness of pharmacists’ consultation in order for atrial fibrillation (AF) patients receiving warfarin to achieve better quality of anticoagulation control. It also aims to identify the factors contributing to the failure or success of reaching the therapeutic INR. A prospective study was carried out in the Warfarin-MTAC that operated in the Cardiac Unit of Serdang and Seremban Hospitals in 2011. Three hundred and fifty-two AF-diagnosed patients were represented in the inclusion criteria, selected using the convenience sampling technique. The patients consist of Malay, Chinese and Indian with the mean age of 64.2 and 64.6 years old, and had the CHADS2 score of 2.3±1.2 and 2.7±1.3 for patients in Serdang and Seremban Hospitals, respectively. Patients’ adherence to warfarin therapy as had been guided by Pharmacist was found to be a factor that contributed to the achievement of good quality of anticoagulation control (Odds ratio: 53.3 and 52.0 at p < 0.05 and CI = 95% for those in Serdang and Seremban Hospitals respectively). The anticoagulation control achieved is ‘good’ with %TTR of (81.1 +21.1)% and (77.9+12.6)% for both hospitals. As a conclusion, to prevent stroke and avoid overwarfarinization, and to ensure effective consultation with pharmacists, the pharmacists should provide comprehensive advice to patients with atrial fibrillation who are receiving warfarin treatment at the Anticoagulation Therapy Clinic and emphasize on the prioritized characteristics for the warfarin therapy.
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The effectiveness of pharmacists’ consultation in order for atrial fibrillation (AF) patients , receiving warfarin to achieve better quality of anticoagulation control.