Auditing the scope of antithrombotic care in iPACT (International Pharmacists for Anticoagulation Care Taskforce) represented countries

Abstract

Countries strive to find suitable solutions to offer health services to their populations. Pharmacist-led services are a possible solution to supplement the care offer with a clear advantage of proximity, with demonstrated expertise in medication use. This paper aims to audit the scope of antithrombotic care services available; and to describe the arrangements adopted for meeting the needs of the population. A multi-stage project involved the development of the list of services, generated during a face-to-face expert meeting; the definition of each service by literature search; and their clustering into three main groups (general, specific and support); resulting in an online audit of each service's availability, the settings where the service was available and the possible providers. The audit was distributed to a taskforce devoted to antithrombotic care representing 22 countries, with response obtained for all. Most reported general services were Transfer of care and Comprehensive Medication Review. Among specific services, Point-of-care testing for INR and renal function and Patient Education on antithrombotic care (antiplatelets and anticoagulants) were the most frequent. Interprofessional Education as a support service was very common, but the use of the Choosing Wisely initiative to inform evidence-based decisions was still limited. There was wide diversity found in arrangements for the provision of services to support patients taking antithrombotic medication, albeit specific services were reported in over half the surveyed countries.

Keywords: Antithrombotic agents; Health services accessibility; Interprofessional relations; Nurses; Pharmacists; Physicians.