Implementation and evaluation of a warfarin patient self-management (PSM) program among experienced patients in a U.S. academic health system

J Thromb Thrombolysis. 2023 Nov;56(4):511-513. doi: 10.1007/s11239-023-02877-9. Epub 2023 Aug 7.

Abstract

Warfarin patient self-management (PSM) is when a patient independently manages their warfarin therapy using a decision-support tool provided by their anticoagulation provider. Clinical trials of PSM, conducted predominantly in Europe, have consistently demonstrated superior efficacy without compromising safety. However, the evidence-based practice of PSM is rarely utilized in the United States (U.S.). We describe initiatives completed to implement a successful PSM program among experienced warfarin-taking patients in a U.S. academic health system by overcoming perceived barriers. The results showed PSM resulted in similar or improved INR control, and an estimated 68% reduction in pharmacist workload.

Keywords: International normalized ratio; Patient education; Pharmacists; Self-management; Warfarin.

MeSH terms

  • Anticoagulants / therapeutic use
  • Blood Coagulation
  • Humans
  • International Normalized Ratio
  • Pharmacists
  • Self-Management*
  • Warfarin* / therapeutic use

Substances

  • Warfarin
  • Anticoagulants