Table of Contents
International Journal of Family Medicine
Volume 2013, Article ID 691454, 4 pages
Research Article

A Pharmacist-Led Point-of-Care INR Clinic: Optimizing Care in a Family Health Team Setting

1Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
2South East Toronto Family Health Team, Toronto, Ontario, Canada
3Department of Family Medicine and the Department of Emergency Medicine at Headwaters Health Care Centre, Orangeville, Ontario, Canada
4North Toronto Research Network, Toronto, Ontario, Canada
5Leslie Dan Faculty of Pharmacy and the Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada

Received 16 July 2013; Accepted 13 October 2013

Academic Editor: Geoffrey Mitchell

Copyright © 2013 Jennifer Rossiter et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Purpose. Monitoring patients’ international normalized ratio (INR) within a family medicine setting can be challenging. Novel methods of doing this effectively and in a timely manner are important for patient care. The purpose of this study was to determine the effectiveness of a pharmacist-led point-of-care (POC) INR clinic. Methods. At a community-based academic Family Health Team in Toronto, Canada, charts of patients with atrial fibrillation managed by a pharmacist with usual care (bloodtesting at lab and pharmacist follow up of INR by phone) from February 2008 to April 2008 were compared with charts of patients attending a weekly POC INR clinic from February 2010 to April 2010. Time in therapeutic range (TTR) was measured for both groups. Results. 119 patient charts were reviewed and 114 had TTR calculated. After excluding patients with planned inconsistent Coumadin use (20), such as initiating Coumadin treatment or stopping for a surgical procedure, the mean TTR increased from 64.41% to 77.09% with the implementation of the POC clinic. This was a statistically significant difference of 12.68% (CI: 1.18, 24.18; ). Conclusion. A pharmacist-led POC-INR clinic improves control of anticoagulation therapy in patients receiving warfarin and should be considered for implementation in other family medicine settings.