Implementation and Evaluation of a Pharmacist-Assisted Warfarin Dosing Program
Bibliographic record
Abstract
ABSTRACT The purpose of this study was to implement a Pharmacy-Assisted Warfarin Dosing (PAWD) Pilot Program and assess its effects on efficiency, effectiveness, and safety during warfarin anticoagulation. A protocol was developed based on institutional anticoagulation guidelines. Pharmacists on three musing units anticoagulated patients by protocol upon physician request (PAWD group, n=24). All warfarin orders were written by a pharmacist in accordance with hospital policies. The study group was compared with a baseline sample of patients started on warfarin therapy by physicians (Control group, n=34). The number of patients achieving the target INR by day 5 (Control - 41.1 % and PAWD - 32 %) was not significantly different among the 2 groups. The PAWD program resulted in significant improvements to the number of warfarin doses administered on time (99.1 %) compared to the Control group (46.2 %). Both groups had a low incidence of bleeding (Control 6.06 % and PAWD - 8 %) and thromboembolic events (Control - 3.03 % and PAWD - 0 %). Overall, the PAWD program resulted in equally effective and safe anticoagulation of patients and improved compliance with timely administration of doses. RESUME Le but de cette etude etait de mettre sur pied un programme pilote de dosage de la warfarine assistee par le pharmacien (DWAP) et d'en evaluer sur l'efficience, l'efficacite et la securite dans le cadre d'une anticoagulotherapie a la warfarine. Un protocole a ete elabore, a partir des lignes directrices institutionelles sur l'anticoagulotherapie. Les pharmaciens de trois unites de soins ont amorce une anticoagulotherapie a des patients selon le protocole etabli, a la demande du medecin (groupe DWAP, N=24). Toutes les demandes de warfarine ont ete ecrites par un pharmacien, selon les politiques de l'hopital. Le groupe experimental a ete compare a un groupe de patients chez qui l'anticoagulotherapie a ete amorcee par des medecins (groupe temoin; N = 34). Le nombre de patients qui a atteint le RIN cible au jour 5 (temoins : 41, 1 % et DWAP : 32 %) n'etait pas significativement different entre les cieux groupes. Le programme DWAP a entraine des ameliorations notables du nombre de doses De warfarine administrees selon l'horaire etabli (99,1 %), comparativement au groupe temoin (46,2 %). L'incidence des saignements (temoins : 6,06 % et DWAP : 8 %) et des thromboembolies (temoins : 3,03 % et DWAP : 0 %) etait faible clans les deux groupes. Dans l'ensemble, le programme DWAP a permis d'administrer d'une facon aussi sure et efficace qu'avec la methode classique l'anticoagulotherapie et de respecter davantage l'horaire d'administration des doses.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.008 | 0.012 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".