Effectiveness of a technological tool associated with pharmaceutical guidance in hospital discharge of patients using warfarin

Abstract

Background: Warfarin is an anticoagulant considered a high-alert medication by the Brazilian Institute for Safe Practices in the Use of Medicines. The clinical pharmacist advises patients on safety and adherence to this therapy. Lack of patient guidance can lead to undesirable outcomes, from readmissions to deaths. Objective: The objective of this study was to evaluate the impact of the use of a technological tool associated with the role of the clinical pharmacist in a tertiary hospital in guiding patients on the use of warfarin. Method: Cohort research with 960 patients using warfarin from 2017 to 2020 and discharged from hospital. Information was compared between the period before (G1) and after (G2) the implementation of the technological tool that searches for specific keywords in real-time in the hospital operating system. Results: A greater range of patients was advised at hospital discharge, going from 57.4% in G1 to 74.9% in G2 (p<0.001). Implementing a technological tool in the hospital system allowed the identification of discharged patients using warfarin in real-time. Internal failures can be avoided by implementing health technologies, as evidenced in our research. Warfarin belongs to a group of high-alert medications; all patients could benefit from technological tools. We understand that despite some perceived limitations, the application achieved the purpose for which it was developed, and its use could, in the future, be extended to other medicines and internal hospital processes. Conclusion: Health technologies can benefit patients and healthcare professionals, as demonstrated by the greater scope of patients guided by clinical pharmacists at hospital discharge. Given the scarcity of similar studies, new strategies must be developed for outpatients and home monitoring.