United Kingdom Clinical Pharmacy Association

Pharmacists at the Medway hospital (Gillingham, Kent) took part in a study of monitoring and adjusting warfarin doses for inpatients, said Mr CHRISTOPHER BODDY (clinical pharmacy services manager, Queen Mary hospital, Sidcup, and formerly of the Medway hospital) who gave the Medeva Pharma award lecture.
At the start of the study, problems with warfarin dosing in inpatients were identified. There were delays in starting warfarin, poor INR control, too frequent measuring of INRs, poor continuity of patient care and poor co-ordination with the outpatient clinic. Pharmacist monitoring followed protocols. Pharmacists achieved significantly better INR control than doctors and also patients reached a therapeutic INR more quickly. Doctors asked for more INR tests because each day, a different junior doctor on call was responsible for warfarin monitoring. At the end of the study, Mr Boddy concluded that specialist pharmacist involvement removed all of the problems initially identified in inpatient warfarin dosing with the exception of delays in starting treatment.

Christopher Boddy