Outpatient Pharmaceutical Care-Warfarin Classroom-.

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Abstract
In order to carry out effective warfarin treatment and to avoid unnecessary adverse reactions, patients need to recognize the importance of drug compliance, food-drug interaction, drug-drug interaction, and matters that require attention in daily life. We therefore have conducted a “Warfarin Classroom” since April 2000 to provide proper information about warfarin to outpatients. We evaluated how did “Warfarin Classroom” changed both the knowledge and recognition in these patients using a scoring system. The number of subjects participating in this study was 136 (110 males, 26 females, average age : 61.8 years). The patients filled in the same questionnaire regarding their knowledge about warfarin before and after the medication counseling. In the questionnaire we allocated one point for one correct answer from the patients. The average value of the total score was 6.4 and 7.8 before and after the counseling, respectively. A significant improvement was thus observed after the counseling. The target values of thrombo test are commonly set up at 10-20% and 20-30% in cardiovascular surgery and vascular surgery, respectively. However these values should be adjusted according to patient's disease conditions and side effects. In our study, the patients who maintained the target value set up by individual were 43 % and 60 % before and after the counseling, respectively. As a result, it was found that our “Warfarin Classroom”, in which pharmacists counsel outpatients regarding how to take to warfarin, was useful for improving knowledge and helping the patients achieve a better outcome by improving the target values for the thrombo test.

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