Evidence map›Paper›PMID 27403212›Full record

ArticleCanadian geriatrics journal : CGJ2016

Advantages of a Warfarin Protocol for Long-term Care Pharmacists: a Retrospective Cohort Study.

Randall Sargent, Cynthia Brocklebank, Helen Tam-Tham, Tyler Williamson, Patrick Quail, Diana Turner, Neil Drummond

Open access · diamondAbstract read
In one paragraph

Article in Canadian geriatrics journal : CGJ, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.6field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 10 citations in OpenAlex.

  1. Review
  2. Article
  3. The June Issue of the CGJ.Canadian geriatrics journal : CGJ · 2016
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 2 countries.

Randall SargentFamily Medicine and Primary Care Research Office, Cumming School of Medicine, University of Calgary, Calgary;; Integrated Supportive and Facility Living, Alberta Health Services, Calgary;; Southern Alberta Primary Care Research Network, University of Calgary, Calgary;
Cynthia BrocklebankPharmacy Services, Alberta Health Services, Edmonton;
Helen Tam-ThamDepartment of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary;
Tyler WilliamsonDepartment of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary;
Patrick QuailIntegrated Supportive and Facility Living, Alberta Health Services, Calgary;; Southern Alberta Primary Care Research Network, University of Calgary, Calgary;
Diana TurnerIntegrated Supportive and Facility Living, Alberta Health Services, Calgary;; Carewest, Calgary;
Neil DrummondDepartment of Family Medicine and Dentistry, University of Alberta, Edmonton, Alberta.
Alberta Health Services · CAUniversity of Calgary · CAUniversity of Alberta · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWarfarin is an anticoagulant prescribed to 12% of long-term care residents to reduce the risk of thrombo-embolism. This study used indicators to compare warfarin management by pharmacists to usual care.

methodsThis was a retrospective cohort study comparing a pharmacist-managed warfarin protocol with usual care of qualified warfarin recipients at long-term care facilities (two protocol, one control) in Calgary, Alberta. We compared the proportion of international normalized ratio (INR) tests in the range 2.0 to 3.0, time in range, number of tests, and frequency of bleeding at protocol and control sites. Our primary outcome, time in INR therapeutic range, is an indicator for assuring care quality. A cross-sectional survey at these sites compared health professionals' perceptions of workload and effectiveness of warfarin management.

resultsOf the 197 residents' charts reviewed in the study period, those on protocol had 45.0 INR tests while those on usual care had 52.7 tests (p = .034, 95% CI for the difference: 0.6 to 14.6 INR tests). No significant difference was found for time in therapeutic range, number of tests in range, or major bleeding events. Of 178 health professionals surveyed, those from protocol facilities were more satisfied with warfarin management (p = .013). Workload and safety were perceived similarly at all sites.

interpretationOur results suggest that a pharmacist-managed warfarin protocol is as effective as usual care and has advantages pertaining to work satisfaction, knowledge of drug interactions, consistent documentation, and fewer INR tests. Further research on teamwork and coagulation management in long-term care facilities is recommended.

Indexed as

anticoagulationcontinuing careinternational normalized ratio (INR)pharmacyprotocolwarfarin

Identifiers

PMID27403212
PMCPMC4922367
OpenAlexW2465817882

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.