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Pharmacist Managed Anticoagulation Service

Pharmacist Managed Anticoagulation Service. Health Workforce New Zealand funded trial Managed by the Pharmaceutical Society of New Zealand Based on positive outcomes of a service started at Pharmacy 547 in Hamilton 15 sites from 112 interested pharmacies

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Pharmacist Managed Anticoagulation Service

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  1. Pharmacist Managed Anticoagulation Service • Health Workforce New Zealand funded trial • Managed by the Pharmaceutical Society of New Zealand • Based on positive outcomes of a service started at Pharmacy 547 in Hamilton • 15 sites from 112 interested pharmacies • Targeted sites in low-decile high needs areas with high Maori and PI populations Dale Griffiths FPS MNZCP RegPharm NZ Westview Pharmacy Vice President PSNZ

  2. CPAMS Trial • Six month trial • 15 pharmacies • 52 Medical practices • > 600 patients • Patients self selected after offer of trial • Oversight committee included 3 GPs • Prof Les Toop • Dr Harry Pert • Dr Claire Hill • Haematologist • Dr Paul Harper • Assessment School of Pharmacy University of Auckland • Prof John Shaw

  3. Outcomes • Compliance • 83.1% of tests on or before due date • Increased accessibility • Patient preference for finger tip rather than a venous sample • Immediacy of result and dose • Better tracking of patients • Improved Therapeutic Treatment Range • 154 patients/6 sites with 6 months prior data • Pre TTR 60.4% • CPAMS 77.5% • Overall TTR 79.2% (min 16 weeks treatment)

  4. CPAMS Community Pharmacy Anticoagulation Monitoring Service Emma HenchmanB.Pharm MPS RegPharmNZ Westview Pharmacy

  5. Four safety questions

  6. INR Report

  7. Treatment Calendar

  8. Improved Time in Range

  9. Improved Patient Compliance

  10. Results posted to PMS • Pharmacist identified • Result, dose and next test date provided

  11. Key points • CPAMS is run under a standing order. • The pharmacist tests and adjusts doses for INR <4. • Patients must be formally referred • Quality Assurance • Internal • At the start of the month and with each new batch • External • Through UK NEQAS an NHS approved QA organisation • Results posted to PMS and Testsafe

  12. “We have been delighted with the programme as it seems that the results have been superior to GP managed warfarin, and it has obviously reduced time pressure on us. The feedback from patients has been particularly positive. They find point of care testing very helpful and reduces communication error... We would ideally like to increase the number of our patients that are currently in the programme” Dr Douglas Horne (on behalf of Drs at Westview medical centre)

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