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BMC Health Serv Res. 2018 Feb 1;18(1):80. doi: 10.1186/s12913-018-2874-7.

A multicenter, prospective study evaluating the impact of the clinical pharmacist-physician counselling on warfarin therapy management in Lebanon.

Author information

1
Lebanese International University, School of Pharmacy, Beirut, Lebanon.
2
Lebanese International University, School of Pharmacy, Beirut, Lebanon. diana.malaeb@liu.edu.lb.
3
American University of Beirut Medical Center, Beirut, Lebanon.
4
Saint-Joseph University, Faculty of Pharmacy, Beirut, Lebanon. souheilhallit@hotmail.com.
5
Holy Spirit University, Faculty of Medicine and Medical Sciences, Kaslik, Lebanon. souheilhallit@hotmail.com.
6
Psychiatric Hospital of the Cross, Research Department, P.O. Box 60096, Jal Eddib, Lebanon. souheilhallit@hotmail.com.
7
Occupational Health Environment Research Team, U1219 BPH Bordeaux Population Health Research Center, Inserm - Université de Bordeaux, Bordeaux, France. souheilhallit@hotmail.com.
8
, Biakout, Lebanon. souheilhallit@hotmail.com.
9
INSPECT-LB: Institut National de Sante Publique, Epidemiologie Clinique et Toxicologie, Faculty of Public Health, Lebanese University, Beirut, Lebanon. souheilhallit@hotmail.com.

Abstract

BACKGROUND:

Health care professionals (HCP) are known key elements of effective patient's counselling and education. For patients taking warfarin, education about the dose, side effects, and toxicity is clearly identified as a cornerstone of achieving improved health and quality of life. The study objective was to evaluate the patients' knowledge about warfarin and assess the impact of the health care professionals' counselling in enhancing patients' knowledge in achieving warfarin therapeutic outcomes.

METHOD:

A six-month prospective multicentered study was conducted in three hospitals, enrolling 300 patients admitted to the cardiac care unit and internal medicine departments. Patients' warfarin knowledge and INR levels were assessed before and after the clinical pharmacist counselling. The main therapeutic outcome was the impact of the clinical pharmacist-physician counselling on improving patient's education and achieving therapeutic INR level.

RESULTS:

A higher mean knowledge about warfarin score was found after counselling as compared to before counselling (4.82 vs 13.2; p < 0.001). Likewise, the drug dose (1.05 vs 1.88), drug toxicity (0.41 vs 1.92), drug-drug and food-drug interactions (0.02 vs 1.89), therapeutic INR and general drug knowledge scores (2.66 vs 4.68) were significantly higher after as compared to before counselling (p < 0.001 for all variables). The percentages of patients who achieved therapeutic INR levels pre/post counselling was 37.2% and 74.4% respectively (p < 0.001).

CONCLUSION:

Based on the study findings, HCP play a major role in enhancing patients' knowledge about the factors that affect warfarin therapeutic outcomes. This study highlights the need to establish and develop strategies for appropriate warfarin utilization in Lebanon.

KEYWORDS:

Clinical pharmacist; Counselling; Patient knowledge; Therapeutic INR; Warfarin

PMID:
29391010
PMCID:
PMC5796596
DOI:
10.1186/s12913-018-2874-7
[Indexed for MEDLINE]
Free PMC Article

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