Impact of a Pharmacist-Led Warfarin Self-Management Program on Quality of Life and Anticoagulation Control: A Randomized Trial

Study Objective To evaluate the impact of a pharmacist‐led warfarin patient self‐management program on quality of life and anticoagulation control compared with management in a physician‐led specialized anticoagulation clinic. Design Prospective, randomized, controlled, open‐label trial. Setting Tertiary care academic medical center. Patients A total of 114 patients aged 18–75 years who were followed at a specialized anticoagulation clinic, had received warfarin for at least 6 months, and were expected to continue warfarin for a minimum of 4 months. Intervention All patients attended an educational session on anticoagulation provided by a pharmacist. Patients randomized to the self‐management group (58 patients) also received practical training to use the CoaguChek XS device and a self‐management dosing algorithm. Patients in the control group (56 patients) continued to undergo standard management at the anticoagulation clinic. Measurements and Main Results Patients completed a validated quality‐of‐life questionnaire and the validated Oral Anticoagulation Knowledge test at the beginning and end of the study. The quality of anticoagulation control was evaluated by using the time spent in therapeutic range. After 4 months of follow‐up, a significant improvement in the self‐management group was observed compared with the control group in four of the five quality‐of‐life topics (p