Comparing tele-pharmacy and standard clinic follow-up for newly initiated warfarin anticoagulation therapy: A retrospective study.

Objectives: To compare the effectiveness of providing telepharmacy anticoagulation to on-site clinics in achieving optimal outcomes for patients newly starting warfarin.

Methods: This single-center retrospective cohort study included adult patients who started warfarin for the first time and were monitored by clinical pharmacists either on-site or via telepharmacy anticoagulation clinics between January 2017 and March 2024. The primary outcome is to compare the time in therapeutic range (TTR) between the 2 groups. The secondary outcome is the occurrence of anticoagulation therapy-related complications.

Results: We included 191 patients, with 77 in the telepharmacy group and 114 in the on-site group. The baseline characteristics were similar for both groups. The primary outcome- time in therapeutic range (TTR)-was not significantly different between thetelepharmacy and the on-site groups (50% versus 53.8%, p=0.455) and remained so after univariable and multivariable adjustments (OR [odd ratio]= 0.63, p=0.14 and OR=0.58, p=0.102). Additionally, there were no significant differences in secondary outcomes, including thromboembolism and bleeding (p=1 for both).

Conclusion: This study demonstrates that patients who receive warfarin for the first time at an anticoagulation clinic can use the telepharmacy method without the fear undesirable outcomes. Results of this study support the continued use and expansion of telepharmacy services in Saudi Arabia. However, further research larger sample sizes and multiple centers is needed to confirm these findings.