Aims To audit the new pharmacist-led telephone service for warfarin dosing and monitoring of INR, and compare it to the previous system. The previous system was based on the paediatric cardiology ward, dosing by junior medical staff to dose and documented on a paper system. Also to audit the parent satisfaction of the new system.
Methods Search the computerised system to reveal 73 patients on warfarin with a total of 1547 INRs, and looked for any complications or out of range results. This to be compared to a previous audit of the original system of 44 patients on warfarin with a total of 1289 INRs.
For parent/carer satisfaction, a questionnaire was sent to parents/carers of all patients who were under the care of the pharmacist-led children's warfarin clinic.
Results The pharmacist-led children's warfarin service was fully compliant for NPSA safety standards for warfarin dosing. There was no significant difference in the safety indicators from the original service and the pharmacist-led service.
11 patients (25%) were lost to follow up from the original service, compared to none in the pharmacist-led service. No patients from either service had an inappropriate target INR and every patient had been given the correct information. 38 out of 53 (72%) parents/carers returned the satisfaction survey. 28 (78%) reported that their overall experience of the clinic was excellent and the rest found it satisfactory.
Discussion Changing to the pharmacist-led service has meant that it is now compliant with NPSA standards and the safety indicators are comparable to the original service. The service has generally been very well received, with all parents/carers finding the service at least satisfactory and 78% found it excellent. The pharmacist-led service is unique, as it uses a computerised system for documentation, with the aim to produce a paediatric dosing algorithm.
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