Search

Until recently, Prothrombin Time/International Normalized Ratio (PT/INR) measurements have typically been used to monitor patients on warfarin through institutional laboratories via venous puncture. The Point-of-Care Testing (POCT) device has revolutionized the patient care process by allowing for laboratory testing outside of the central laboratory. Objective: To analyze humanistic and clinical outcomes in patients currently treated with warfarin and monitored through a pharmacist-managed anticoagulation clinic using point-of-care testing (POCT) device versus venipuncture within ambulatory care clinics at our institution. Methods: All patients currently treated with warfarin therapy who were managed by clinical pharmacists for anticoagulation monitoring at the Medical University of South Carolina (MUSC) Family Medicine Center and University Diagnostic Center, were enrolled. Patients were asked to complete a satisfaction survey regarding their anticoagulation monitoring. In addition, data related to emergency department (ED) visits, hospitalizations and percent of time in the INR therapeutic range for 6 months pre- and post-implementation of POCT device was collected. This information was obtained through an electronic patient information database, Oacis. Results: A total of 145 patients were included in the data collection from the two clinics. The majority (41%) of these patients were taking warfarin for atrial fibrillation. Satisfaction surveys were completed by 86 (59 %) of patients. The surveys revealed that POCT device was preferred over venipuncture in 95% of patients. Reasons for the preference included more face-to-face interaction, less wait time, less pain, less blood needed, and quicker results. Of the 145 patients who were included in the objective data analysis, no significant differences were found in the number of hospitalizations, ED visits, or percent of time in the INR therapeutic range pre- and post- implementation of POCT device.Conclusion: The results of this study demonstrate improvement in patient satisfaction with POCT compared to venipuncture, with limited value in clinical outcomes.

The purpose of this one-year observational study was to evaluate quality of life in patients at the Medical University of South Carolina Family Medicine clinic who were followed by a clinical pharmacist diabetes educator.Methods: Patients who have been seen by the clinical pharmacist for diabetes education and management services were contacted by telephone and asked to complete a previously validated Diabetes-related Quality of Life (DRQL) survey. In addition, the patient’s most recent hemoglobin A1C, blood pressure, fasting lipid panel and aspirin use were obtained from the electronic medical record. Correlation and logistic regression analysis was completed in order to assess the quality of life score and clinical outcomes.Results: A total of 47 patients completed the survey (37%). The median overall score was 1 (1-very satisfied; 5-very dissatisfied). Patients who were more satisfied with their current treatment tended to have lower LDL, systolic and diastolic blood pressure (BP) values (r=0.32, 0.3, 0.33; p=0.03, 0.03, 0.02). In addition, patients taking more medications were more dissatisfied with the amount of time spent managing their disease (r=0.29, p=0.04), felt more pain associated with the treatment of their disease (r=0.32, p=0.02), and were more worried that their body looked different as a result of their diabetes (r=0.32, p=0.02). Conclusion: Patients in this clinic were highly satisfied with their quality of life. The authors found that trends exist for relationships between several important clinical parameters and quality of life.