Pharmaceutical Care Issues in Patients with Atrial Fibrillation Receiving Thromboprophylaxsis

Muhammad Junaid Farrukh^1, , Shairyzah Ahmad Hisham¹ and Zainol Akbar bin Zainal¹

¹Faculty of Pharmacy, Cyberjaya University College of Medical Sciences, Malaysia

Cite this paper:
Muhammad Junaid Farrukh, Shairyzah Ahmad Hisham and Zainol Akbar bin Zainal. Pharmaceutical Care Issues in Patients with Atrial Fibrillation Receiving Thromboprophylaxsis. American Journal of Pharmacological Sciences. 2014; 2(5B):12-16. doi: 10.12691/ajps-2-5B-4

Abstract

Thromboprophylaxis is the mainstay therapy for preventing thromboembolic events such as stroke in Atrial Fibrillation patients. Patients with moderate or high risk of stroke should receive warfarin as it has shown to be superior in clinical trials, with increase in relative reduction of stroke and similar incidence of bleeding compared to aspirin alone. A descriptive cross-sectional study was designed to assess common types and frequencies of PCIs in AF patients receiving thromboprohylaxis and use of thromboprophylactic agents in accordance to stroke risk stratification. Retrospective data was collected by reviewing medical record of hundred patients diagnosed with AF receiving thromboprophylaxis admitted in Serdang Hospital between January-December 2012. Patients were chosen using random sampling technique from PIS data base of the hospital with the help of random number table software. Pharmacist Workup of Drug Therapy (PWDT) form by the Ministry of Health, Government of Malaysia used for patient evaluation in all the hospitals of Malaysia was modified according to the research objectives of the study and was used as data collection tool. Out of 100 patients (n=56 %) were females while n = 44 (44 %) were males. The mean age for males was 60.93 years ± 7.64 and females was 62.84 ± 13.52 years. A total of 15% patients were not treated according to CPG recommendations regarding thromboprophylaxis. The mean CHA2DS2VASc score was (3.3,± 1.1) while mean SD HAS-BLED (bleeding risk) score was (1.37, ± 0.92). A total of 274 pharmaceutical care issues were identified. The most common pharmaceutical care issues were drug-drug interaction (n=143), non-compliance to treatment (n=31), drug-food interaction (n=16), non-compliance to dietary requirements (n=15) and lack of patient counselling (n=35).The study reported identification of varieties of PCIs in AF patients receiving thromboprophylaxis which supports the need of dedicated clinical pharmacist to work in collaboration with healthcare team and patients.

Keywords:
thromboprophylaxis CHA2DS2VASc Score Stroke

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