Journal of Pharmacy Management - Jan 2022

Journal of Pharmacy Management • Volume 38 • Issue 1 • January 2022 pre-pandemic; 26% of those patients were switched to a DOAC, 19% were enrolled onto the self-testing scheme, with a further 6% switched to GP/District Nurse monitoring. The 3 initiatives accounted for a 51% reduction in patient footfall at 6 months. A two-tailed t-test was used to analyse the difference in the mean%TIR between the two periods. The mean %TIR over a 60-day period at baseline (January - February 2020) across all clinic INR targets was 75.4%, compared to 74.7% at 6 months (July - August 2020). The results show that there was no significant difference between the mean %TIR at baseline and at 6 months as p>0.05 (p= 0.93). Discussion This transformation project has not only reduced patient footfall across the Trust by 51% but also had a positive impact on patient care during the COVID-19 pandemic. Initiatives that were implemented during this transformation project improved cross interface collaboration with primary care, empowered patients by giving them independence and autonomy to self- test INRs and we brought care closer to the patient’s home. This is particularly current with The NHS Long Term Plan which has set out key ambitions for the service over the next 10 years. One of the key priorities is to give patients more control over the care they receive and encourage greater collaboration between secondary care, GPs and community services. 8 Impact of local INR testing – Even though only 6% of patients were having INR checks locally during the pandemic, RBHH still managed the responsibility of dosing these patients. We recognise that this was the least sustainable option of the initiatives we implemented as some patients will be repatriated back to the Trust in the long term. However, the links built with primary care during this process were invaluable. This enabled us to share our experience and specialist expertise around the management of anticoagulation, which will give us more opportunity to develop shared specialist learning across the care 9 Target Range 1-5 – 2.5 (Target 2.0) 2.0 – 3.0 (Target 2.5) 2.5 – 3.5 (Target 3.0) 3.0 – 4.5 (Target 3.75) 3.0 – 4.0 (Target 3.5) Days on Treatment 146 7979 3031 84 1160 Days in range 130 5597 2147 70 695 % TIR 89.04 70.14 70.83 83.33 59.91 Figure 4: VKA Clinic Percentage (%) Time in Therapeutic Range (%TIR) by INR target at 6 months (July – August 2020) Target Range 1-5 – 2.5 (Target 2.0) 2.0 – 3.0 (Target 2.5) 2.5 – 3.5 (Target 3.0) 3.0 – 4.5 (Target 3.75) 3.0 – 4.0 (Target 3.5) Days on Treatment 262 14794 3092 44 1288 Days in range 185 10946 2142 44 811 % TIR 70.61 73.99 69.28 100 62.97 Figure 3: VKA Clinic Percentage (%) Time in Therapeutic Range (%TIR) by INR target at Baseline (January - February 2020)