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Record W3093968049 · doi:10.1177/0840470420969444

A novel model of care in anticoagulation management

2020· review· en· W3093968049 on OpenAlexaff
Lisa Woodill, Allison Bodnar

Bibliographic record

VenueHealthcare Management Forum · 2020
Typereview
Languageen
FieldMedicine
TopicAtrial Fibrillation Management and Outcomes
Canadian institutionsNova Scotia Hospital
Fundersnot available
KeywordsWarfarinPharmacistMedicinePharmacyDosingActivity-based costingHealth careMedication therapy managementMedical prescriptionMedical emergencyIntensive care medicineEmergency medicineFamily medicineNursingBusinessInternal medicine

Abstract

fetched live from OpenAlex

For over 60 years, warfarin has been the treatment of choice in the prevention of strokes and other thromboembolic events. In recent years, a new class of Novel Oral Anticoagulant (NOAC) medication has become available, leaving clinicians and health system payors to question whether warfarin continues to have a place in therapy. This article argues that it may not be the medication that should be in question but instead the systems in place to manage anticoagulation for the patients who need it. Usual Care (UC) for warfarin management has traditionally required multiple healthcare visits, blood collection visits, and laboratory analysis of International Normalized Ratio (INR) with results to then later be relayed to the patient along with dosage adjustments. The article reviews a new model of care, Community Pharmacist-led Anticoagulation Management Service (CPAMS), in which patients receive a point-of-care INR test along with a pharmacist assessment at a pharmacy and results within minutes. Pharmacists then prescribe dosage adjustments immediately, counsel patients, and provide supporting adherence tools such as a colourful picture-based dosing calendar, created by the decision support tool, INR Online. The Nova Scotia CPAMS Demonstration Project shows that this model will result in efficiencies for healthcare providers and optimal anticoagulation with improved time in therapeutic range outcomes for patients. In addition, the CPAMS Costing Study finds the model to be a cost-effective solution for health systems when compared to UC for warfarin as well as NOAC patients.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMeta-epidemiology (narrow)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: none
GenreCandidate signal: Review · Consensus signal: Review
Teacher disagreement score0.976
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0010.000
Meta-epidemiology (broad)0.0020.001
Bibliometrics0.0010.001
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

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.

Opus teacher head0.153
GPT teacher head0.415
Teacher spread0.262 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designNot applicable
Domainnot available
GenreReview

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".

Quick stats

Citations9
Published2020
Admission routes1
Has abstractyes

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