Effectiveness of Dosage and Pills Calculator Program in Warfarin Clinic Kantararom Hospital, Si Sa Ket Province

Abstract

Warfarin is an anticoagulant drug used to prevent and treat blood clots such as deep vein thrombosis, pulmonary embolism and to prevent stroke. Because of a narrow therapeutic index, the warfarin dose must be calculated in accordance with the patient's INR (International Normalized Ratio) for effectiveness of treatment and safety drug use. Developing dosage and pills calculator program in warfarin clinic Kantararom Hospital aimed to study: (1) Keep INR level and time in therapeutic range (TTR) more than 60 percent. (2) Reduce risk and prevent adverse effect from warfarin (3) Reduce time to calculate warfarin dosage and pills count. Material and method: This experimental research calculated sample size was 180 patients used a warfarin calculator program and data were collected before and after using the program with pharmaceutical care record in warfarin clinic. Data were analyzed into percentage, mean, standard deviation, range, Paired sample t-test and Chi-square. Results: (1) The mean TTR after using the dose calculation program was significantly increased from 40.99% ± 21.78 percent to 65.11 ± 27.5 percent. (p-value <0.001). (2) Chi-square test for medication error about the number of pills does not fit on the scheduled date, order overdose warfarin and choose wrong medication order decreased significantly (p-value <0.05). (3) Adverse events about bleeding with any INR were decrease significantly (p-value <0.05). (4) The average time to calculate warfarin dosage and pills decreased significantly from 5.37± 1.55 to 0.45 ± 0.75 minutes (p-value <0.001). Conclusion: Warfarin clinic should be use drug system management planning program to calculate dose and pills for keep INR in target range for reduce medication errors and adverse events.