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International Journal of Clinical Pharmacy

, Volume 39, Issue 1, pp 41–44 | Cite as

Improvement of time in therapeutic range with warfarin by pharmaceutical intervention

  • Alvaro Víquez-Jaikel
  • Victoria Hall-Ramírez
  • Allan Ramos-EsquivelEmail author
Short Research Report

Abstract

Background Anticoagulation therapy with warfarin is highly effective for prevention and treatment of thromboembolic disorders. Nevertheless, its management is challenging especially in developing countries, where the medical access is difficult and patient education is poor. Objective To determine the effect of pharmaceutical intervention (PI) on the time in therapeutic range (TTR) of a group of anticoagulated patients from our referral center. Method A group of consecutive outpatients previously treated by usual medical care underwent PI. The intervention consisted in the identification and avoidance of food and drug interactions, the confection of medication schedule charts and education to patients regarding side effects and drug monitoring. Mean TTR before and after PI was compared through the Wilcoxon test for repeated measures. Regression analyses were performed to assess the relationship between a TTR level under 65% and potential explanatory variables. Results Mean TTR before PI was 37.4 ± 23.5% and after PI it raised to 67.0 ± 24.9%. Mean change in TTR was +29.5% (95% CI 14.5–44.6; p < 0.001). Before PI only 4 patients had TTR values above 65%, in contrast to 18 patients after PI. Conclusion Our findings support the efficacy of PI to improve TTR values in patients treated with warfarin.

Keywords

Anticoagulants Costa Rica Drug monitoring International normalized ratio Pharmaceutical intervention Warfarin 

Notes

Funding

No specific funding was received for this project.

Conflicts of interest

The authors have no conflict of interest with regard to this publication.

Supplementary material

11096_2016_403_MOESM1_ESM.docx (17 kb)
Supplementary material 1 (DOCX 17 kb)

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Copyright information

© Springer International Publishing 2016

Authors and Affiliations

  1. 1.Unidad de Atención FarmacéuticaHospital San Juan de Dios, Caja Costarricense de Seguro SocialSan JoséCosta Rica
  2. 2.Farmacia HospitalariaUniversidad Autónoma de Ciencias MédicasSan JoséCosta Rica
  3. 3.Centro de Información de Medicamentos, Escuela de FarmaciaUniversidad de Costa RicaSan JoséCosta Rica
  4. 4.Departamento de Farmacología, Escuela de MedicinaUniversidad de Costa RicaSan JoséCosta Rica

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