Impact of Clinical Pharmacist Running Anticoagulation Clinic in Saudi Arabia
Abstract
:1. Introduction
2. Method
2.1. Study Design and Setting
2.2. Models of Care
2.3. Eligibility Criteria
2.4. Data Extraction
2.5. Study Outcome
2.6. Sample Size Calculation
2.7. Statistical Analysis
2.8. Ethics Approval
3. Results
4. Discussion
5. Limitations
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Gender | Male N (%) | Female N (%) | p-Value |
50 (52.08) | 46 (47.92) | p = 0.683 | |
Age Group (Years) | Male N (%) | Female N (%) | p-Value |
15–24 | 4 (8) | 0 (0) | --------- |
25–34 | 6 (12) | 4 (8.7) | p = 0.527 |
35–44 | 4 (8) | 4 (8.7) | p = 1.000 |
45–54 | 16 (32) | 6 (13.04) | p = 0.033 |
55–64 | 10 (20) | 22 (47.83) | p = 0.034 |
65–74 | 2 (4) | 8 (17.39) | p = 0.058 |
75–84 | 2 (4) | 2 (4.35) | p = 1.000 |
85–94 | 6 (12) | 0 (0) | --------- |
Total | 50 (52.08) | 46 (47.92) | |
Smoking Habits | Male N (%) | Female N (%) | p-Value |
88 (91.6) | 8 (8.4) | p = 0.000 | |
Type of Diseases | Male N (%) | Female N (%) | p-Value |
AF | 4 (8) | 0 (0) | --------- |
HTN | 4 (8) | 4 (8.7) | p = 1.000 |
VD | 28 (56) | 28 (60.87) | p = 1.000 |
ACS | 4 (8) | 2 (4.35) | p = 0.414 |
HTN + Diabetes | 10 (20) | 12 (26.09) | p = 0.670 |
Total | 50 (100) | 46 (100) |
Indications | N (%) | p-Value |
---|---|---|
AVR–Mechanical | 4 (4.17) | p = 0.000 |
Atrial fibrillation | 8 (8.33) | |
Dual AVR and MVR | 16 (16.67) | |
Intracardiac thrombus | 12 (12.5) | |
MVR–Bioprosthetic | 18 (18.75) | |
MVR–Mechanical | 32 (33.33) | |
PE and Stroke | 2 (2.02) | |
Stroke | 2 (2.02) | |
Valvular Disease | 2 (2.02) | |
Total | 96 (100) |
Type of Clinical Pharmacist’s Intervention | 1st Visit | 2nd Visit | 3rd Visit | 4th Visit | 5th Visit | p-Value | |||||
---|---|---|---|---|---|---|---|---|---|---|---|
N | % | N | % | N | % | N | % | N | % | ||
Medication reconciliation (Yes) | 96 | 100 | 96 | 100 | 96 | 100 | 96 | 100 | 96 | 100 | |
Medication discontinuation (Yes) | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | |
Hold the medication (Yes) | 4 | 4.2 | 2 | 2.1 | 0 | 0.0 | 0 | 0.0 | 2 | 2.1 | |
Drug addition (Yes) | 0 | 0.0 | 0 | 0.0 | 2 | 2.1 | 0 | 0.0 | 0 | 0.0 | |
Drug change (Yes) | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | |
Dose adjustment (Yes) | 38 | 39.6 | 38 | 39.6 | 30 | 31.2 | 20 | 20.8 | 4 | 4.2 | p = 0.000 |
ADR reporting (Yes) | 4 | 4.2 | 2 | 2.1 | 0 | 0.0 | 0 | 0.0 | 0 | 0.0 | |
Patient counseling (Yes) | 96 | 100 | 96 | 100 | 96 | 100 | 96 | 100 | 96 | 100 | |
Physicians’ recommendation (Yes) | 50 | 52.1 | 50 | 52.1 | 50 | 52.1 | 20 | 20.8 | 14 | 14.6 |
Change in Weekly Dose | |||||||
---|---|---|---|---|---|---|---|
Drug | Baseline | 1st Visit | 2nd Visit | 3rd Visit | 4th Visit | 5th Visit | p-Value |
Weekly Dose (mg) (Mean ± SD) | 28.99 ± 11.81 | 27.74 ± 12.28 | 28.33 ± 11.45 | 29.48 ± 12.05 | 30.70 ± 12.58 | 31.60 ± 13.35 * | 0.001 |
Dose Range (Min–Max) | 52.50 (3.50–56) | 47 (8–55) | 47 (9–56) | 43 (10–56) | 43 (12–55) | 42.5 (12–54.5) | 0.001 |
Change in Weekly INR | |||||||
INR Value | Baseline | 1st Visit | 2nd Visit | 3rd Visit | 4th Visit | 5th Visit | p-Value |
INR (Mean ± SD) | 2.87 ± 1.31 | 2.5 ± 0.95 * | 2.63 ± 0.82 * | 2.62 ± 0.79 * | 2.58 ± 0.58 * | 2.63 ± 0.47 * | 0.001 |
INR Range (Min–Max) | 5.02 (1.10–6.12) | 5.32 (1.38–6.70) | 3.8 (1.1604.96) | 4.55 (1.01–5.56) | 2.64 (1.47–3.91) | 0.4 (1.64–4.26) | 0.001 |
Number of Patients | ||||||
---|---|---|---|---|---|---|
Adverse Drug Reactions | Baseline N (%) | 1st Visit N (%) | 2nd Visit N (%) | 3rd Visit N (%) | 4th Visit N (%) | 5th Visit N (%) |
Nose bleeding | 6 (6.3) | 4 (4.2) | 2 (2.1) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
Reasons of Not Achieving Target INR | Baseline N (%) | 1st Visit N (%) | 2nd Visit N (%) | 3rd Visit N (%) | 4th Visit N (%) | 5th Visit N (%) |
Non-compliance | 18 (18.8) | 24 (25) | 16 (16.7) | 8 (8.3) | 4 (4.2) | 2 (2.1) |
Dose hypersensitivity | 2 (2.1) | 0 (0.0) | 0 (0.0) | 0 (0.0) | 2 (2.1) | 0 (0.0) |
Sub-therapeutic dose | 2 (2.1) | 0 (0.0) | 0 (0.0) | 2 (2.1) | 0 (0.0) | 0 (0.0) |
No follow-up | 16 (16.7) | 6 (6.3) | 6 (6.3) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
Drug–Drug interaction | 0 (0.0) | 0 (0.0) | 4 (4.2) | 0 (0.0) | 0 (0.0) | 0 (0.0) |
Unknown reason | 40 (41.7) | 12 (12.5) | 12 (12.5) | 18 (18.8) | 2 (2.1) | 0 (0.0) |
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Alshaiban, A.; Alavudeen, S.S.; Alshahrani, I.; Kardam, A.M.; Alhasan, I.M.; Alasiri, S.A.; Imam, M.T.; Almalki, Z.S.; Akhtar, M.S. Impact of Clinical Pharmacist Running Anticoagulation Clinic in Saudi Arabia. J. Clin. Med. 2023, 12, 3887. https://doi.org/10.3390/jcm12123887
Alshaiban A, Alavudeen SS, Alshahrani I, Kardam AM, Alhasan IM, Alasiri SA, Imam MT, Almalki ZS, Akhtar MS. Impact of Clinical Pharmacist Running Anticoagulation Clinic in Saudi Arabia. Journal of Clinical Medicine. 2023; 12(12):3887. https://doi.org/10.3390/jcm12123887
Chicago/Turabian StyleAlshaiban, Abdulrahman, Sirajudeen S. Alavudeen, Ibrahim Alshahrani, Abdulaziz M. Kardam, Ibrahim Mohammed Alhasan, Saleh Abdulrahman Alasiri, Mohammad Tarique Imam, Ziyad Saeed Almalki, and Md Sayeed Akhtar. 2023. "Impact of Clinical Pharmacist Running Anticoagulation Clinic in Saudi Arabia" Journal of Clinical Medicine 12, no. 12: 3887. https://doi.org/10.3390/jcm12123887