A Case Study of Pharmacists Supporting a Heart Failure Patient for 16 Years from PT-INR Monitoring during the Waiting Period until Transplantation

DOI
  • Nakamura Ikuyo
    クオール株式会社 クオールアカデミー・教育研修部
  • Sato Miyako
    クオール株式会社 クオールアカデミー・教育研修部
  • Oomukai Kaori
    クオール株式会社 クオールアカデミー・教育研修部
  • Naganuma Mika
    クオール株式会社 クオールアカデミー・教育研修部

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Other Title
  • 心不全患者との16年間に及ぶ関わりの中で、心臓移植の待機から移植までのPT-INRモニタリングを薬剤師がサポートした1症例

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Abstract

Warfarin often interacts with other medications, and it is therefore critical to monitor the prothrombin time-international normalized ratio (PT-INR) of a patient’s blood during its administration period. In this study, we describe a case in which we provided PT-INR monitoring and aftercare support for a patient wearing a ventricular assist device (VAD) as a bridge to transplantation (BTT), from the standpoint of a pharmacist. The patient first became a customer of our pharmacy in ‘Year 0.’ She was placed on the heart transplant recipient list in Year 12. Four months later, she was equipped with a VAD, and received a heart transplant in Year 16. During the process of medical treatment associated with her heart transplant, the number of medical institutions she regularly attended as an outpatient increased to four. We sought collaboration with these institutions to share the patient’s laboratory data and thus reduce her blood-sampling load. To protect the patient from anxiety, we also continuously provided her with encouragement. We did this by creating an environment in which the patient was able to enjoy peace of mind: for example, we offered a 24-hour telephone counseling service, and I obtained the qualification of a caregiver for HeartMate II® (VAD) users. Through this case, we reached the view that active intervention by pharmacists in the treatment of patients can lead to the reduction of their psychosomatic and mental burden.

Journal

  • Applied Therapeutics

    Applied Therapeutics 11 (0), 60-66, 2019

    Japanese Society for Applied Therapeutics

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