PMID- 28735551
OWN - NLM
STAT- MEDLINE
DCOM- 20180129
LR  - 20220331
IS  - 1542-6270 (Electronic)
IS  - 1060-0280 (Linking)
VI  - 51
IP  - 12
DP  - 2017 Dec
TI  - Quality of Pharmacist-Managed Anticoagulation Therapy in Long-Term Ambulatory 
      Settings: A Systematic Review.
PG  - 1122-1137
LID - 10.1177/1060028017721241 [doi]
AB  - OBJECTIVE: To perform a systematic review to evaluate the quality of warfarin 
      anticoagulation control in outpatient pharmacist-managed anticoagulation services 
      (PMAS) compared with routine medical care (RMC). DATA SOURCES: MEDLINE, SCOPUS, 
      EMBASE, IPA, CINAHL, and Cochrane CENTRAL, from inception to May 2017. Search 
      terms employed: ("pharmacist-managed" OR "pharmacist-provided" OR 
      "pharmacist-led" OR "pharmacist-directed") AND ("anticoagulation services" OR 
      "anticoagulation clinic" OR "anticoagulation management" OR "anticoagulant care") 
      AND ("quality of care" OR "outcomes" OR "bleeding" OR "thromboembolism" OR 
      "mortality" OR "hospitalization" OR "length of stay" OR "emergency department 
      visit" OR "cost" OR "patient satisfaction"). STUDY SELECTION AND DATA EXTRACTION: 
      Criteria used to identify selected articles: English language; original studies 
      (comments, letters, reviews, systematic reviews, meta-analyses, editorials were 
      excluded); warfarin use; outpatient setting; comparison group present; time in 
      therapeutic range (TTR) included as a measure of quality of anticoagulant 
      control; study design was not a case report. DATA SYNTHESIS: Of 177 articles 
      identified, 25 met inclusion criteria. Quality of anticoagulation control was 
      better in the PMAS group compared with RMC in majority of the studies (N = 23 of 
      25, 92.0%). Clinical outcomes were also favorable in the PMAS group as evidenced 
      by lower or equal risk of major bleeding (N = 10 of 12, 83.3%) or thromboembolic 
      events (N = 9 of 10, 90.0%), and lower rates of hospitalization or emergency 
      department visits (N = 9 of 9, 100%). When reported, PMAS have also resulted in 
      cost-savings in all (N=6 of 6, 100%) of studies. CONCLUSIONS: Compared with 
      routine care, pharmacist-managed outpatient-based anticoagulation services 
      attained better quality of anticoagulation control, lower bleeding and 
      thromboembolic events, and resulted in lower health care utilization.
FAU - Manzoor, Beenish S
AU  - Manzoor BS
AD  - 1 University of Illinois at Chicago, Chicago, IL, USA.
FAU - Cheng, Wei-Han
AU  - Cheng WH
AD  - 2 University of Southern California, Los Angeles, CA, USA.
FAU - Lee, James C
AU  - Lee JC
AD  - 1 University of Illinois at Chicago, Chicago, IL, USA.
FAU - Uppuluri, Ellen M
AU  - Uppuluri EM
AD  - 1 University of Illinois at Chicago, Chicago, IL, USA.
FAU - Nutescu, Edith A
AU  - Nutescu EA
AD  - 1 University of Illinois at Chicago, Chicago, IL, USA.
LA  - eng
PT  - Journal Article
PT  - Review
PT  - Systematic Review
DEP - 20170722
PL  - United States
TA  - Ann Pharmacother
JT  - The Annals of pharmacotherapy
JID - 9203131
RN  - 0 (Anticoagulants)
RN  - 5Q7ZVV76EI (Warfarin)
SB  - IM
MH  - Ambulatory Care Facilities/*statistics & numerical data
MH  - Anticoagulants/adverse effects/*therapeutic use
MH  - Humans
MH  - *Pharmacists
MH  - Professional Role
MH  - Quality of Health Care
MH  - Treatment Outcome
MH  - Warfarin/adverse effects/*therapeutic use
OTO - NOTNLM
OT  - anticoagulation
OT  - long-term ambulatory setting
OT  - outpatient anticoagulation services
OT  - pharmacist
OT  - pharmacist-managed
OT  - quality of anticoagulation control
OT  - warfarin
EDAT- 2017/07/25 06:00
MHDA- 2018/01/30 06:00
CRDT- 2017/07/25 06:00
PHST- 2017/07/25 06:00 [pubmed]
PHST- 2018/01/30 06:00 [medline]
PHST- 2017/07/25 06:00 [entrez]
AID - 10.1177/1060028017721241 [doi]
PST - ppublish
SO  - Ann Pharmacother. 2017 Dec;51(12):1122-1137. doi: 10.1177/1060028017721241. Epub 
      2017 Jul 22.