항응고약물상담(ACS)에서 방문상담과 전화상담의 효과 비교
Outcomes of Anticoagulation Service Monitored by Telephone vs. In-office visits
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Background : Anticoagulation service(ACS) provided by pharmacist offers safe and effective use of warfarin. In Seoul National University Hospital, clinical pharmacists run telephone-based and traditional office-based ACS. There are no studies about effectiveness of the different ways of ACS for Korean patients. The objective of this study was to compare warfarin-related monitoring outcomes and complications in anticoagulation clinic patients whose management was conducted by telephone or in-office based visits. Moreover, we conducted a survey about patients' satisfaction for two kinds of services. Methods : A total 388 patients were enrolled; 194 patients managed by telephone were compared to 194 patients managed in office-based visits. Retrospective methods were used to evaluate clinical outcomes such as time in therapeutic INR values and complication episodes. Patient satisfaction was assessed using 5-point scale. Results : Slightly high percentage of therapeutic INR values was found in office visits group (82% vs. 76%, p=0.04). Bleeding events were more frequently occurred in office visits group (64vs. 44, p=0.03). However major bleeding events were similar between groups (5 vs. 6, p=0.83). No thromboembolic event was found. In aspect of patient satisfaction, same
Abstract
Background : Anticoagulation service(ACS) provided by pharmacist offers safe and effective use of warfarin. In Seoul National University Hospital, clinical pharmacists run telephone-based and traditional office-based ACS. There are no studies about effectiveness of the different ways of ACS for Korean patients. The objective of this study was to compare warfarin-related monitoring outcomes and complications in anticoagulation clinic patients whose management was conducted by telephone or in-office based visits. Moreover, we conducted a survey about patients' satisfaction for two kinds of services. Methods : A total 388 patients were enrolled; 194 patients managed by telephone were compared to 194 patients managed in office-based visits. Retrospective methods were used to evaluate clinical outcomes such as time in therapeutic INR values and complication episodes. Patient satisfaction was assessed using 5-point scale. Results : Slightly high percentage of therapeutic INR values was found in office visits group (82% vs. 76%, p=0.04). Bleeding events were more frequently occurred in office visits group (64vs. 44, p=0.03). However major bleeding events were similar between groups (5 vs. 6, p=0.83). No thromboembolic event was found. In aspect of patient satisfaction, same
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