Objective: To assess the prescribing pattern and pharmacist intervention in anti-coagulation at a tertiary care teaching hospital, Coimbatore, India

Methodology: Data was gathered utilizing a well-structured data collection structure which includes patient's demographics, clinical data which includes (indication for anticoagulation therapy, wanted INR range, anticipated length of therapy, anticoagulation therapy got), social propensities, past medical history, current prescriptions and the prescribed oral anticoagulant (Warfarin/Acitrom). INR values were observed for the patients remembered for the investigation and dosage adjustment was finished by standard convention dependent on the INR value. The patients were also provided with effective counseling regarding the therapy and dietary modifications. All the patients were monitored for any adverse drug events/effects or any possible drug and food interactions during the study period. In case of any reported adverse events/drug associations in the anticoagulation facility, the legitimate intervention was finished by the clinical pharmacist in relationship with a physician to accomplish objective drug therapy.

Result: During our study period, 86 patients were forwarded by the physicians to the clinical pharmacist managing the oral anticoagulation clinic. Only 70 patients could complete the study, where 4 patients did not visit the clinic, other 12 patients did not meet the inclusion criteria and hence they are excluded. The data were collected using data collection form for the study sample. After the interventional study, there was a significant improvement in patients maintaining % of INRs which were in target therapeutic range, % of TTR along with decreased adverse effects. It was also found that the patient’s awareness of the target INR values is correlated with the improved accuracy of anticoagulation control. Hence, our study results reflect the need for a clinical pharmacist in oral anticoagulation management and the necessity of implementing anticoagulation services in various hospital settings.

Conclusion: the clinical pharmacist managing anticoagulation service was able to achieve the INRs of the patient in to target therapeutic range by proper and timely dose adjustments based on the INR value, to identify adverse drug reactions/ adverse events, drug-drug interactions, and drug-food interactions and bring about proper interventions by working in association with physicians.

Keywords: anticoagulant, Clinical pharmacist intervention, INR results, Physician intervention,