Strategic Implementation of an anticoagulation management service in a community-based pharmacy practice setting

The drug warfarin is used for the prevention or treatment of arterial and venous thrombosis. Managing this drug is challenging due to its narrow therapeutic window, as well as, ongoing, time-consuming, laboratory blood tests to avoid potentially life-threatening complications. With the introduction of point-of-care testing technology, pharmacists have an opportunity to provide an alternative and more effective anticoagulation management solution to this monitoring process. Through physician-pharmacist-patient collaboration, pharmacists can provide a differentiated service involving on-site INR blood tests, medication management, and disease management. External forces, such as health reform due to rising costs, increase utilization of prescriptions, and a growing demand for better health services from an aging population, opens the door for pharmacists to take a leadership role in primary health care. The timing has never been better for community pharmacists to offer anticoagulation services. Business leaders must decide what level of involvement is best for their organization. Three differentiated anticoagulation management strategies exist, depending on the firm’s internal capabilities. Factors such as organizational culture, management preferences and resource commitments are integral to supporting the appropriate strategy.