The qualities of a pharmacist-managed warfarin protocol in long-term care


Randall Sargent, Cynthia Brocklebank, Paddy Quail, Diana Turner, Tyler Williamson, Helen Tam, Neil Drummond


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Sargent R, Brocklebank C, Tam-Tham H, Williamson T, Quail P, Turner D, Drummond N. Advantages of a warfarin protocol for long-term care pharmacists: a retrospective cohort study. Can Geriatr J 2016; 19(2):40-49




Warfarin is an anticoagulant prescribed to 12% of long-term care (LTC) residents to reduce the risk of thrombo-embolism. This study used quality assurance indicators to compare warfarin management by pharmacists to usual care.


This was a retrospective cohort study comparing a pharmacist-managed warfarin protocol with usual care of qualified warfarin recipients at LTC facilities (two protocol, one control) in Calgary, Alberta. We compared the proportion of international normalized ratio (INR) tests in the range 2.0 to 3.0, time in range, number of tests, and frequency of bleeding at protocol and control sites. A cross-sectional survey at these sites compared health professionals’ perceptions of workload and effectiveness of warfarin management.


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