PB0586 - Successful Implementation of a Pharmacist-Led Anticoagulation Clinic (ACC) in the Era of Direct Oral Anticoagulants (DOACs) use in Venous Thromboembolism - A Pilot

Background: VTE is a chronic illness necessitating prolonged follow-up to ensure treatment adherence and bleeding risk mitigation considering the dynamic patient-specific risk profiles. Conventionally, patients receiving DOACs were reviewed in physicians' clinics. However, there is growing interest in integrating pharmacists in the management of long-term anticoagulation using DOACs in addition to the traditional anticoagulants.

Aims: We aim to evaluate the effectiveness of pharmacist-led DOACs clinic in terms of patient’s anticoagulation knowledge, safety, satisfaction and pharmacists' perspectives on the feasibility of this service.

Methods: From April to December 2023, patients with newly diagnosed VTE on DOACs were enrolled and surveyed 1 week after their clinic visit. The Short Form Health Survey version 2 (SF-12v2), composed of physical component scores (PCS) and mental component scores (MCS), was used to assess quality of life. Patients on warfarin were the comparator. Pharmacists were also surveyed about their confidence and competence in managing DOACs.

Results: Five patients on DOACs and nine patients on warfarin were surveyed. All were familiar with their anticoagulant regimen and side effects. Both groups reported 100% adherence to anticoagulation. There were no adverse events reported or readmission for VTE or bleeding complications. No patients dropped out from both groups. All were satisfied with the VTE education, waiting time and communication with the pharmacists. The option of teleconsultation or in-person review suited their needs; 40% and 66.7% of patients on DOACs and warfarin respectively preferred teleconsultation. 100% would recommend the service to others. Both the SF-12 PCS and MCS scores were comparable in both groups, not achieving statistical significance. Pharmacists were confident and competent in managing DOACs.

Conclusion(s): The multidisciplinary care involving pharmacist-led DOACs clinic achieved excellent patient experience with good safety outcomes. Together with teleconsultation, this provides a new model that supports pharmacists to offer additional health services in addition to the traditional anticoagulation clinic.