EVALUATION OF A DESIGNED COMMUNITY-BASED POST -DISCHARGE WARFARIN MANAGEMENT PROTOCOL ON IRAQI PATIENTS

Introduction: The warfarin management programs include mainly routine INR measurement, dosing protocols, clinical management protocols for excessive anticoagulation, and patient education. There have been numerous investigations to explore the most appropriate model for outpatients, accordingly different Anticoagulation Management Programs have been emerged in practice. Aims and objectives: This study is an attempt to develop concise warfarin protocol that expands role for the community pharmacist in Iraq. Patients and methods: A prospective case-controlled carried out on patients discharged from the hospital on warfarin therapy in combination to their prescribed medications. The follow up was achieved by four visits starting from 8-10 days after hospital discharge until 90 days. patients who were allocated into Intervention group received designed warfarin management program , and control group on ‘usual care’ monitoring. Results: The percentage of patients with international normalized ratio (INR) levels is within therapeutic/target range in the intervention group was significantly higher than that in the control group (66.67% vs. 34.78%) after 90 days of monitoring program (p˂0.05). During 90 days of follow up, the total percentage of time therapeutic range (TTR) for the intervention group was (57.68%), and (44.92%) for the control group. Patient adherence to warfarin was (100%) in intervention group compared to control group (p˂0.05). Conclusions: The intervention group demonstrated higher percentage of patients with INR levels within therapeutic/target range, following the management program, and significant improvement in time therapeutic range (TTR) from admission to 90 days post discharge. Accordingly, many promising strategies emerged from pharmacist warfarin- management program.