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Study shows how community pharmacy can provide a better patient experience for anticoagulation monitoring

09 February 2018

Latest work from Boots UK and the University of Brighton has demonstrated that community pharmacy is ideally placed to provide a safe anticoagulation service for patients needing warfarin monitoring, delivering enhanced clinical outcomes and patient experience.

Published recently in the journal BMC Health Services Research, the evaluation tracked over 2,000 patients on warfarin who were using the Community Pharmacy Anticoagulation Management Service between 2009 and 2016 in Brighton and Hove. Previously, these patients would have needed to attend regular hospital outpatient clinics to have blood samples taken to assess their International Normalised Ratio (INR) readings, but now are able to access this service from their local community pharmacy, improving patient convenience along with accessibility of the service.

Patient outcomes were shown to exceed targets for patients using the service (percentage INR readings in therapeutic range (65.4%) and percentage time in therapeutic range (72.5%), versus targets of 60% and 70% respectively). The study also showed high levels of patient satisfaction with the service, with over 98.6% of patients rating the service as good, very good or excellent.

Marc Donovan, Chief Pharmacist at Boots UK said: “Anticoagulation management continues to evolve rapidly, and using learnings from studies such as this helps to find opportunities where services can also adapt. As a pharmacy-led service, the community setting can increase patient access to professional advice and testing, ultimately leading to improved INR control.

“This study is important in demonstrating the role that community pharmacy has and continues to have in adapting to meet the changing need of patients, and supports the commissioning of key services from primary care settings.”

Samantha Ingram, Boots Teacher Practitioner at the University of Brighton, said: “Anticoagulants are essential for helping prevent blood clots and our collaborative research showed that providing this service at local community pharmacies proved practicable and helpful for patients.”

The study ran after Brighton and Hove Clinical Commissioning Group made the decision to shift this service from the secondary care setting into local community pharmacies.

James Morton, Commissioning Manager – Urgent and Community, Brighton and Hove Clinical Commissioning Group, said: “The Community Pharmacy Anticoagulation Management Service has proven consistently popular with our patients, by providing accessible clinics closer to home rather than having to travel to attend a hospital appointment.  Recent innovations such as piloting self-testing for a specific cohort of patients have further enhanced patient experience, particularly for people who work.  Brighton and Hove’s GP’s also highly value the service and it provides an invaluable bridge between primary and secondary care services.”

Pharmacists are well placed to take on the role of practitioner in this field as their knowledge of drug interactions, pharmaceutical products, pharmacokinetic principles and counselling skills enables them to effectively manage patients safely within agreed treatment protocols.

The full report is available here: http://rdcu.be/GtXC