Publication Type:

Journal Article


Indian Journal of Pharmaceutical Sciences, Volume 75, Number 1, p.53-59 (2013)



adult, anticoagulant agent, article, atorvastatin, ayurvedic drug, bleeding, brain hemorrhage, cerebrovascular accident, clinical article, controlled study, counseling, deep vein thrombosis, drug safety, female, fluconazole, food drug interaction, gastrointestinal symptom, gingiva bleeding, heart atrium fibrillation, heart valve prosthesis, hematoma, human, ibuprofen, international normalized ratio, knowledge, leafy vegetable, lung embolism, male, mitral valve replacement, occult blood, outcome assessment, pharmacist, prospective study, randomized controlled trial, rash, side effect, thrush, valvuloplasty, warfarin


Anticoagulants are very useful medications but can also lead to haemorrhagic as well as thromboembolic complications when not used correctly or without proper medical attention. Anticoagulant's complex pharmacology and pharmacokinetics contribute to its narrow margin of safety. Pharmacist's unique knowledge of pharmacology, pharmacokinetics and interactions makes them well-suited to assist patients in maintaining safe and effective anticoagulation. Successful anticoagulation therapy implies fewer incidences of therapeutic failures and bleeding complications. The anticoagulation management service staffed by clinical pharmacists is a service established to monitor and manage oral and parenteral anticoagulants. In this research work, 40 patients each were included in the intervention and the control groups. In the intervention group, patient's knowledge score on anticoagulation increased from an average of 5.6±3.2 to 13.8±0.94 (P=0.000) after clinical pharmacist's counselling, whereas in the control group there was no significant improvement in patient's baseline knowledge over the knowledge score at the end of the study (8.0±1.59 vs. 8.3±2.6) (P=0.218). In the intervention group, 73.45% of the international normalised ratio test results were within the therapeutic range, 8.45% supratherapeutic and 18.5% subtherapeutic during the 6 months data collection period. The corresponding data for the control group were 53.2 (P=0.000), 18.4 (P=0.000) and 28.4% (P=0.002), respectively. Forty four adverse drug reactions (ADRs) related to anticoagulants were identified in the intervention group as compared to 56 in the control group. These results revealed that the clinical pharmacist's involvement in the anticoagulation management improved the therapeutic outcome of patients and demonstrate the benefits of clinical pharmacist guided anticoagulation clinics in India.


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Cite this Research Publication

Ra Lakshmi, Emmanuel James, and Kirthivasan, Rb, “Study on impact of clinical pharmacist's interventions in the optimal use of oral anticoagulants in stroke patients”, Indian Journal of Pharmaceutical Sciences, vol. 75, pp. 53-59, 2013.