Delivering Integrated Care and Cost Management
The IHTC works collaboratively with payors to optimize care. We ensure that the patients and families we serve have access to care and therapies, thereby helping to contain costs and reduce both bleeding events and utilization of resources.
The IHTC Pharmacy’s ability to purchase clotting factor through the Public Health Service 340B discount program and our overall pricing structure benefit payors and patients by dispensing clotting factor at significantly reduced prices.
Medical literature has documented that patients who are regularly seen in an anticoagulation clinic have fewer episodes of major bleeding and recurrent blood clots compared with patients who receive care outside of these specialty clinics.1-5 These improved outcomes are likely a result of a multidisciplinary approach, including close follow-up with care providers and more frequent therapeutic monitoring.
The IHTC’s anticoagulation clinic uses a multidisciplinary comprehensive approach for treatment of patients on anticoagulation therapy (e.g., warfarin [Coumadin®] or low molecular weight heparin). The anticoagulation clinic is led by physician assistants experienced in the treatment of clotting (thrombotic) disorders. A board certified hematologist is available on-site as needed. Each patient’s medical status is reviewed with a hematologist after the anticoagulation clinic visit. Anticoagulation clinic staff are supported as-needed by the IHTC’s physical therapist (for strengthening exercise therapy, especially involving clot-related pain and leg swelling), registered dietitian, genetic counselor, and social worker (largely involving insurance coverage counseling). Visit our Meet the Staff section to learn more about the IHTC’s professionals.
Patients using anticoagulation therapy are seen at least every six months in the anticoagulation clinic. In clinic, patients receive education about anticoagulation therapy, are monitored for dietary and drug interactions with their particular anticoagulant, and receive information on their specific genetic or acquired defect, if relevant. Moreover, counseling for management of symptoms is provided. Periodically additional laboratory tests may be required, either to monitor the effectiveness of therapy or to provide additional information related to contributing factors. Some laboratory studies may be obtained to detect early signs of and help prevent adverse events.
The IHTC’s anticoagulation clinic is held weekly. For more information about the clinic, contact the center at 317.871.0000 (toll free 877-256 8837 [877- CLOTTER]).
- Jones C, Lacombe G. Enhancing patient care via a pharmacist-managed rural anticoagulation clinic. Health Q. 2009;Oct;13 Spec No:69-74.
- Bungard TJ, Gardner L, Archer SL, et al. Evaluation of a pharmacist-managed anticoagulation clinic: Improving patient care. Open Med. 2009;3:16-21.
- Nichol MB, Knight TK, Dow T, Wygant G, et al. Quality of anticoagulation monitoring in nonvalvular atrial fibrillation patients: comparison of anticoagulation clinic versus usual care. Ann Pharmacother. 2008;42:62-70.
- Francavilla CL. Registered nurse-managed anticoagulation clinic: improving patient outcomes. Nurs Econ. 2008;26:130-132.
- Nochowitz B, Shapiro NL, Nutescu EA, et al. Effect of a warfarin adherence aid on anticoagulation control in an inner-city anticoagulation clinic population. Ann Pharmacother. 2009;43:1165-72.