A Comparison of Warfarin Monitoring Service Models

Syed Shahzad Hasan, Wendy Sunter, Nadia Ahmed, Alice Royle-Pryor, Amina Brkic, Ramisha Ahmed, Saima Afzal, Zaheer Ud Din Babar

Research output: Contribution to journalArticle

Abstract

Background: Warfarin-related knowledge and patient satisfaction with warfarin monitoring services are generally high with respect to anticoagulation-related care received. Providing a cost-effective warfarin monitoring service while improving warfarin-related knowledge, patient safety and satisfaction can be challenging. Objectives: To compare ‘post and dose’ service offered by the Calderdale Royal Hospital (CRH) and ‘face-to-face’ service offered by Huddersfield Royal Infirmary (HRI) in terms of costs of service delivery, patient satisfaction, warfarin-related knowledge and safety indicators. Methods: A cross-sectional sample of 160 patients on long-term warfarin therapy from anticoagulation (outpatient) clinics at CRH and HRI using interviewer-administered data collection form. International Normalized Ratio (INR), Time in Therapeutic Range (TTR) and Variance Growth Rate (VGR) values of last 12 months and the data on costs of service delivery, knowledge and satisfaction were collected. Results: Patients monitored at HRI had higher mean VGR value (0.35 ± 0.62 vs. 0.17 ± 0.17, p = 0.092) and slightly lower mean TTR (68.70 ± 19.43 vs. 69.63 ± 17.71, p = 0.756) compared with CRH patients. Patients monitored in ‘post and dose’ were estimated at a price of £11.06 per patient per visit and each patient in face-to-face service only cost £9.70 per visit. Patients monitored at HRI had marginally higher overall knowledge score (65.22 ± 23.29 vs. 60.31 ± 20.93, p = 0.165) and overall satisfaction score (15.59 ± 3.16 vs. 15.05 ± 3.10, p = 0.279) compared with CRH patients. A positive and significant correlation was found between patients’ knowledge and patient satisfaction (r = +0.327, p = 0.001). Conclusion: Although, HRI provided monitoring service at a slightly lower cost than CRH, patients monitored at CRH had better anticoagulation control and favourable indicators. Warfarin-related knowledge needs to be improved to achieve further improvement in quality of warfarin use.

LanguageEnglish
JournalResearch in Social and Administrative Pharmacy
Early online date30 Oct 2018
DOIs
Publication statusE-pub ahead of print - 30 Oct 2018

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Warfarin
Monitoring
Patient Satisfaction
Costs and Cost Analysis
Costs
International Normalized Ratio
Patient Safety
Growth
Quality Improvement
Ambulatory Care Facilities
Therapeutics
Interviews
Safety

Cite this

@article{7208e8a1318a4db283963503f7421db1,
title = "A Comparison of Warfarin Monitoring Service Models",
abstract = "Background: Warfarin-related knowledge and patient satisfaction with warfarin monitoring services are generally high with respect to anticoagulation-related care received. Providing a cost-effective warfarin monitoring service while improving warfarin-related knowledge, patient safety and satisfaction can be challenging. Objectives: To compare ‘post and dose’ service offered by the Calderdale Royal Hospital (CRH) and ‘face-to-face’ service offered by Huddersfield Royal Infirmary (HRI) in terms of costs of service delivery, patient satisfaction, warfarin-related knowledge and safety indicators. Methods: A cross-sectional sample of 160 patients on long-term warfarin therapy from anticoagulation (outpatient) clinics at CRH and HRI using interviewer-administered data collection form. International Normalized Ratio (INR), Time in Therapeutic Range (TTR) and Variance Growth Rate (VGR) values of last 12 months and the data on costs of service delivery, knowledge and satisfaction were collected. Results: Patients monitored at HRI had higher mean VGR value (0.35 ± 0.62 vs. 0.17 ± 0.17, p = 0.092) and slightly lower mean TTR (68.70 ± 19.43 vs. 69.63 ± 17.71, p = 0.756) compared with CRH patients. Patients monitored in ‘post and dose’ were estimated at a price of £11.06 per patient per visit and each patient in face-to-face service only cost £9.70 per visit. Patients monitored at HRI had marginally higher overall knowledge score (65.22 ± 23.29 vs. 60.31 ± 20.93, p = 0.165) and overall satisfaction score (15.59 ± 3.16 vs. 15.05 ± 3.10, p = 0.279) compared with CRH patients. A positive and significant correlation was found between patients’ knowledge and patient satisfaction (r = +0.327, p = 0.001). Conclusion: Although, HRI provided monitoring service at a slightly lower cost than CRH, patients monitored at CRH had better anticoagulation control and favourable indicators. Warfarin-related knowledge needs to be improved to achieve further improvement in quality of warfarin use.",
author = "Hasan, {Syed Shahzad} and Wendy Sunter and Nadia Ahmed and Alice Royle-Pryor and Amina Brkic and Ramisha Ahmed and Saima Afzal and Babar, {Zaheer Ud Din}",
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A Comparison of Warfarin Monitoring Service Models. / Hasan, Syed Shahzad; Sunter, Wendy; Ahmed, Nadia; Royle-Pryor, Alice; Brkic, Amina; Ahmed, Ramisha; Afzal, Saima; Babar, Zaheer Ud Din.

In: Research in Social and Administrative Pharmacy, 30.10.2018.

Research output: Contribution to journalArticle

TY - JOUR

T1 - A Comparison of Warfarin Monitoring Service Models

AU - Hasan,Syed Shahzad

AU - Sunter,Wendy

AU - Ahmed,Nadia

AU - Royle-Pryor,Alice

AU - Brkic,Amina

AU - Ahmed,Ramisha

AU - Afzal,Saima

AU - Babar,Zaheer Ud Din

PY - 2018/10/30

Y1 - 2018/10/30

N2 - Background: Warfarin-related knowledge and patient satisfaction with warfarin monitoring services are generally high with respect to anticoagulation-related care received. Providing a cost-effective warfarin monitoring service while improving warfarin-related knowledge, patient safety and satisfaction can be challenging. Objectives: To compare ‘post and dose’ service offered by the Calderdale Royal Hospital (CRH) and ‘face-to-face’ service offered by Huddersfield Royal Infirmary (HRI) in terms of costs of service delivery, patient satisfaction, warfarin-related knowledge and safety indicators. Methods: A cross-sectional sample of 160 patients on long-term warfarin therapy from anticoagulation (outpatient) clinics at CRH and HRI using interviewer-administered data collection form. International Normalized Ratio (INR), Time in Therapeutic Range (TTR) and Variance Growth Rate (VGR) values of last 12 months and the data on costs of service delivery, knowledge and satisfaction were collected. Results: Patients monitored at HRI had higher mean VGR value (0.35 ± 0.62 vs. 0.17 ± 0.17, p = 0.092) and slightly lower mean TTR (68.70 ± 19.43 vs. 69.63 ± 17.71, p = 0.756) compared with CRH patients. Patients monitored in ‘post and dose’ were estimated at a price of £11.06 per patient per visit and each patient in face-to-face service only cost £9.70 per visit. Patients monitored at HRI had marginally higher overall knowledge score (65.22 ± 23.29 vs. 60.31 ± 20.93, p = 0.165) and overall satisfaction score (15.59 ± 3.16 vs. 15.05 ± 3.10, p = 0.279) compared with CRH patients. A positive and significant correlation was found between patients’ knowledge and patient satisfaction (r = +0.327, p = 0.001). Conclusion: Although, HRI provided monitoring service at a slightly lower cost than CRH, patients monitored at CRH had better anticoagulation control and favourable indicators. Warfarin-related knowledge needs to be improved to achieve further improvement in quality of warfarin use.

AB - Background: Warfarin-related knowledge and patient satisfaction with warfarin monitoring services are generally high with respect to anticoagulation-related care received. Providing a cost-effective warfarin monitoring service while improving warfarin-related knowledge, patient safety and satisfaction can be challenging. Objectives: To compare ‘post and dose’ service offered by the Calderdale Royal Hospital (CRH) and ‘face-to-face’ service offered by Huddersfield Royal Infirmary (HRI) in terms of costs of service delivery, patient satisfaction, warfarin-related knowledge and safety indicators. Methods: A cross-sectional sample of 160 patients on long-term warfarin therapy from anticoagulation (outpatient) clinics at CRH and HRI using interviewer-administered data collection form. International Normalized Ratio (INR), Time in Therapeutic Range (TTR) and Variance Growth Rate (VGR) values of last 12 months and the data on costs of service delivery, knowledge and satisfaction were collected. Results: Patients monitored at HRI had higher mean VGR value (0.35 ± 0.62 vs. 0.17 ± 0.17, p = 0.092) and slightly lower mean TTR (68.70 ± 19.43 vs. 69.63 ± 17.71, p = 0.756) compared with CRH patients. Patients monitored in ‘post and dose’ were estimated at a price of £11.06 per patient per visit and each patient in face-to-face service only cost £9.70 per visit. Patients monitored at HRI had marginally higher overall knowledge score (65.22 ± 23.29 vs. 60.31 ± 20.93, p = 0.165) and overall satisfaction score (15.59 ± 3.16 vs. 15.05 ± 3.10, p = 0.279) compared with CRH patients. A positive and significant correlation was found between patients’ knowledge and patient satisfaction (r = +0.327, p = 0.001). Conclusion: Although, HRI provided monitoring service at a slightly lower cost than CRH, patients monitored at CRH had better anticoagulation control and favourable indicators. Warfarin-related knowledge needs to be improved to achieve further improvement in quality of warfarin use.

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