Pharmacists are at least as good as other professionals at monitoring medications to prevent blood clots

Hou K, Yang H, Wang Y, et al. Effectiveness of pharmacist-led anticoagulation management on clinical outcomes: A systematic review and meta-analysis Journal of Pharmacy and Pharmaceutical Sciences. 2017;20(1):378-396. 

Review Question

• When compared to other professionals, do pharmacists help reduce excessive bleeding when monitoring blood-clot-prevention medication?

Background

• Many blood and heart-related conditions are treated by monitoring medication levels in the blood, but this is a difficult task.
• Currently, blood-clot-prevention medications can be monitored by pharmacists, physicians, nurses and even patients themselves, however, it is unclear who is most effective at doing so. Monitoring levels of medication to prevent blood clots is important as they are associated with a significant risk of bleeding and hemorrhage.
• Some research suggests that pharmacists may be more effective at managing blood-clot-prevention medication than other professionals.

How the review was done

• A detailed search of a number of electronic databases for studies published up to 2017 was conducted. Studies that assessed medication monitoring by pharmacists were included in the review.
• A total of 4,245 studies were identified in searches, and 16 were included in the review after assessments for eligibility.
• The authors did not acknowledge any funding sources for this review.

What the researchers found

• Pharmacists monitoring medications did not prevent major bleeding events or better control medication levels in the blood when compared to other professionals.
• Researchers found that pharmacists monitoring blood-clot-prevention medications were more effective than other professionals at reducing risk of minor bleeding events.
• Some studies suggested that patients were more satisfied when pharmacists monitored the use of blood-clot-prevention medication, and that the total cost was less than other professionals.

Conclusion

• Overall, pharmacists were at least as effective (but not more effective) than other professionals at monitoring blood-clot-prevention medications in order to prevent major bleeding events and control medication levels in the blood. Pharmacists were found to be more effective at reducing risk of minor bleeding events. Some studies suggest that patients have higher satisfaction with pharmacist monitoring and that the total cost is less, but these results need to be confirmed by further research.