Development of a Pharmaceutical Care Information Referral System for Warfarin Patients

Abstract

Background: Treatment outcomes and adverse reactions can be monitored by pharmaceutical care data transferring and systematic problem solving. Kantharalak Hospital developed a system for transferring pharmaceutical information of warfarin users by using S/O/A/P in information technology.

Objectives: To develop a system for transferring pharmaceutical information to warfarin users and to assess treatment outcomes and drug safety both before and after system development.

Methods: This action research consisted of 4 phases: phase 1 preparation, phase 2 implementation, phase 3 observation and data collection, and phase 4 reflection and conducted in the fiscal year 2020-2022. Sample group were all patients with at least two hospital warfarin prescriptions each fiscal year. Data were analyzed by descriptive statistics and independent t-test.

Results: The development of systematic data storage and transferring model provided continuity in the pharmaceutical care process, the data collecting and reporting were more convenient. The proportion of the total warfarin patients who achieved the target INR level (INR 2.0 – 3.0) was 54.3%, 55.6%, and 55.5%, respectively in the fiscal year 2020, 2021, and 2022. The percentage of times which each patient achieved the target INR in the fiscal year 2022 significantly decreased from 2020 and 2021, p = 0.020 and 0.003 respectively. Those receiving pharmaceutical care achieved the target INR level of 73.5% in 2021 and raised to 76.1% in 2022. Regarding drug safety, the cause of the outside target INR occurred 96.0% in 2021 and decreased to 72.3% in 2022. It was found that between 2020 and 2022, the risk in the drug system tended to decrease. The minor and preventable risk level A, B, and C was found 31, 20, and 26 times, respectively. The serious and dangerous risks level D, E was found 12, 8, and 1 times respectively.

Conclusion: The development of a pharmaceutical care information transfer system for warfarin patients could support patient care, improve treatment outcomes, and increase patient safety.