Journal of Pharmacy Management - Jan 2022

Journal of Pharmacy Management • Volume 38 • Issue 1 • January 2022 The aim of this project was to improve patient safety by reducing the footfall of patients to the outpatient clinics which we successfully reduced by a half, whilst changing the service we delivered to meets the needs of our patients at a time of uncertainty. There were no significant differences in the times of our patients %TIR pre pandemic versus after introducing our initiatives and remodelling our cohort to a 50% self- testing anticoagulation service. Despite the challenges of switching patients onto the self-testing scheme and co-ordinating tests and results across care boundaries during a period where services were stretched, we were still able to maintain safe and effective anticoagulation management and monitoring for our clinic patients. We recommended a combination of strategies to meet the needs of patients during the pandemic, with the help of new technologies to also help create a sustainable, more responsive model in the future. We will take away lessons learned during this process to continue to develop and embed forward-thinking initiatives into practice, ensuring we continually improve the patient- centred care we deliver to patients on anticoagulant therapy. Declaration of interests The authors have no interests to declare. Acknowledgments Wewould like to thank Gillian Dunning, Anticoagulation Clinical Nurse Specialist and the Cardiothoracic Surgery Pharmacy Team for their help and support with this project. 11 REFERENCES 1. Picton, C. and Wright, H. 2013. Medicines Optimisation: Helping Patients To Make The Most Of Medicines. Royal Pharmaceutical Society. 2. Public Heath England. 2020. Coronavirus (COVID-19): guidance. Available at: https://www.gov.uk/government/collections/coronavirus-covid-19-list-of-guidance [A ccessed 6/3/2021] 3. Department of Health and Social Care. Public Health England. Guidance on shielding and protecting people who are clinically extremely vulnerable from COVID-19. Updated 25th February 2021. Available at: https://www.gov.uk/government/publications/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid- 19/guidance-on-shielding-and-protecting-extremely-vulnerable-persons-from-covid-19 [accessed 05/03/2021] 4. NHS England, NHS Improvement. Clinical Guide for the Management of Anticoagulant Services During the Coronavirus Pandemic. Publications approval reference, 001559. November 2020 5. Williams H. Guidance for the Safe Switching of Warfarin to Direct Oral Anticoagulants (DOACs) for Patients With Non-Valvular AF and Venous Thromboembolism (DVT / PE) During the Coronavirus Pandemic. Royal College of General Practitioners and British Society of Haematology. March 2020 6. National Institute for Health and Care Excellence. 2014. Overview | Atrial Fibrillation And Heart Valve Disease: Self-Monitoring Coagulation Status Using Point-Of-Care Coagulometers (The Coaguchek XS System) | Guidance | NICE. [online] Available at: https://www.nice.org.uk/guidance/dg14 [Ac cessed 01/09/2020]. 7. Sunderji, R., Gin, K., Shalansky, K., Carter, C., Chambers, K., Davies, C., Schwartz, L. and Fung, A., 2005. Clinical Impact of Point-of- Care vs Laboratory Measurement of Anticoagulation. American Journal of Clinical Pathology, 123(2), pp.184-188. 8. National Health Service (NHS) London Clinical Networks. 2020. Pan London framework for adult patients who self-monitor their INR [PDF]. Available at: https://aftoolkit.co.uk/wp-content/uploads/2020/05/pan-london-framework-for-adult-patients-self- monitoring-of-inr-2.pdf (aftoolkit.co.uk) [Accessed 6/3/2021]