(C-240) Impact and Assessment of Medication Therapy Management Services on Oral Anticoagulants: A Patient-Centric Based Approach

Background: Oral anticoagulants are high-risk medications and multifaceted patient understanding is required to encourage safe and effective oral anticoagulants use. Medication Therapy Management services has been proven to be effective to the pharmacist to collaborate with healthcare professionals for betterment of patients who are on multiple medications.

Objectives: To assess the effectiveness of medication therapy management services on the knowledge and adherence of patients prescribed with oral anticoagulants.

Methods: A prospective observational cohort study was conducted in a tertiary care academic hospital. Patients prescribed with oral anticoagulants and who were attending and admitted to the hospital in surgery, cardiology, and cardiothoracic surgery departments were recruited in the study. Patient education tools were constructed and used to assess the knowledge and adherence with the help of validated questionnaires which were then administered in the patients prescribed with oral anticoagulants. A pharmacist who is trained in medication therapy management conducted the medication therapy management sessions. The medication therapy management sessions were according to the American Pharmacists Association (Version 2.0). The knowledge and adherence outcomes of the patients were assessed at baseline, 4 months and 8 months of medication therapy management services. The outcomes were evaluated using repeated measures of ANNOVA with a p-value of < 0.05 was considered statistically significant.

Results: A total of 100 patients participated in the study. The mean age of the study population was 51. The commonly prescribed oral anticoagulant was acenocoumarol (34%) followed by warfarin (29%). The baseline knowledge and adherence scores were 43.40 and 51.59. The knowledge and adherence scores after providing medication therapy management services were approximately 71.38 and 80.45 during the 4-month interval and 82.97 and 88.56, during the 8-month interval respectively. Most of the adverse medication effects of oral anticoagulants were observed with international normalized ratio (INR) more than 6.

Conclusions: The pharmacist-led medication therapy management services significantly improved the knowledge (p=0.000) and adherence (p=0.000) of the patients treated with oral anticoagulants. Anticoagulation management services will assist in determining the patient's disease condition and emphasizes their course of therapy. The pharmacist's role in such services will be helpful for physicians to optimize and maintain the dose and reduce the overall medication related problems.