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01.12.2018 | Research article | Ausgabe 1/2018 Open Access

BMC Health Services Research 1/2018

A multicenter, prospective study evaluating the impact of the clinical pharmacist-physician counselling on warfarin therapy management in Lebanon

Zeitschrift:
BMC Health Services Research > Ausgabe 1/2018
Autoren:
Nermine S. Choumane, Diana N. Malaeb, Bassem Malaeb, Souheil Hallit
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1186/​s12913-018-2874-7) contains supplementary material, which is available to authorized users.

Abstract

Background

Health care professionals (HCP) are known key elements of effective patient’s counselling and education. For patients taking warfarin, education about the dose, side effects, and toxicity is clearly identified as a cornerstone of achieving improved health and quality of life. The study objective was to evaluate the patients’ knowledge about warfarin and assess the impact of the health care professionals’ counselling in enhancing patients’ knowledge in achieving warfarin therapeutic outcomes.

Method

A six-month prospective multicentered study was conducted in three hospitals, enrolling 300 patients admitted to the cardiac care unit and internal medicine departments. Patients’ warfarin knowledge and INR levels were assessed before and after the clinical pharmacist counselling. The main therapeutic outcome was the impact of the clinical pharmacist-physician counselling on improving patient’s education and achieving therapeutic INR level.

Results

A higher mean knowledge about warfarin score was found after counselling as compared to before counselling (4.82 vs 13.2; p < 0.001). Likewise, the drug dose (1.05 vs 1.88), drug toxicity (0.41 vs 1.92), drug-drug and food-drug interactions (0.02 vs 1.89), therapeutic INR and general drug knowledge scores (2.66 vs 4.68) were significantly higher after as compared to before counselling (p < 0.001 for all variables). The percentages of patients who achieved therapeutic INR levels pre/post counselling was 37.2% and 74.4% respectively (p < 0.001).

Conclusion

Based on the study findings, HCP play a major role in enhancing patients’ knowledge about the factors that affect warfarin therapeutic outcomes. This study highlights the need to establish and develop strategies for appropriate warfarin utilization in Lebanon.
Zusatzmaterial
Additional file 1: Patient’s knowledge evaluation questionnaire. Questionnaire we used during the data collection. (DOCX 28 kb)
12913_2018_2874_MOESM1_ESM.docx
Literatur
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