Efficacy and safety of pharmacist-led vs. Physician-led anticoagulation care in Saudi hospital

The effective management of thromboembolic disorders heavily rely on oral anticoagulants. Attaining the best control, monitoring, and patient compliance with anticoagulation therapy is crucial for ensuring its safe and effective application. This study sought to compare the efficacy and safety outcome between clinics led by pharmacists and those led by physicians for anticoagulation management. The study evaluated two primary endpoints: the proportion of international normalized ratio values within the target range (%TTR) for warfarin treatment and the appropriateness of DOAC therapy. Secondary endpoints encompassed the percentage of time spent within the preferred INR range, occurrences of significant bleeding, and instances of thrombosis necessitating visits to the emergency department or hospitalisations. The primary endpoints were %TTR for warfarin and the appropriateness of DOAC therapy. Secondary outcomes assessed safety through bleeding and thrombotic events. The pharmacist-led cohort demonstrated a %TTR of 62%, compared to 70% in the physician-led cohort (P=0.073). DOAC therapy showed no significant differences between the groups in terms of indication, dosage, and duration (p=0.527, p=0.555, and p=0.627, respectively). Minor bleeding was significantly higher in the pharmacist-led group (12.3% vs. 2.7%, p<0 p=0.004),>