Pustaka Ilmiah Universitas Padjadjaran

Abstrak

Effects Of Pharmacist Counseling On Compliance And International Normalized Ratio Score On Outpatients Receiving Warfarin At Dr. Hasan Sadikin Bandung Hospital West Java, Indonesia

Objective: Warfarin is a derivate of coumarin, which is usually prescribed as an oral anticoagulant for treatment and prevention of thromboembolic disorders. The aim of present research is to analyze the influence of pharmacist counseling on compliance and international normalized ratio (INR) score recovery on warfarin management. Methods: Design in this research used mixed method, combination of qualitative and quantitative method. Qualitative data were used for completing quantitative data. Qualitative method used a content analysis with interview. Quantitative method used a quasi-experimental method with control groups, pre-test, and post-test design. Data were analyzed by Wilcoxon test and Mann–Whitney test at significance level p=0.05 and multivariate analysis covariate. Results: Data were collected from 80 patients with rheumatic heart disease (42.5%), atrial fibrillation (17.5%), deep vein thrombosis (10%), rheumatic mitral valve disease (10%), prosthetic heart (7.5%), other (22.5%). The numbers of patients whose INR was in the therapeutic range for each indication was not statistically different between before and after receiving counseling (p>0.05), Patients’ behavior compliance of warfarin therapy had increased after receiving the counseling service (p<0.05). The result of presents research is pharmacist counseling affected behavior compliance before and after counseling (p<0.05) but not for INR (p>0.05). Conclusion: Pharmacist counseling can improve behavior compliance but not improve INR target. The effect of warfarin to every individual not only affected by behavior compliance but also several factors could influence effect of warfarin is clinical factors, non-clinical factors, and genetic factors. Clinical factors that were influenced were age, gender, pharmacokinetic and pharmacodynamic variability in patients.