Evaluating the Effectiveness of Pharmacist-Managed Warfarin Therapy Clinics at Cardiology Centers in Kano State, North West Nigeria

Warfarin therapy management requires meticulous monitoring of the international normalized ratio and individualized dose adjustments to balance thromboembolism prevention against bleeding risk. Pharmacist-managed anticoagulation clinics have demonstrated superior outcomes internationally compared to physician-only management. This study evaluated the effectiveness of pharmacist-managed warfarin therapy clinics at cardiology centres in Kano State, North West Nigeria. A retrospective comparative study analyzed outcomes of patients managed by pharmacist-led anticoagulation clinics in two centres against a control group under standard physician management in two comparable centres over 18 months. Primary outcomes included time in therapeutic range, bleeding events, thromboembolic events, and international normalized ratio monitoring frequency. Secondary outcomes were patient adherence and quality of life using the Anticlot Treatment Scale. Among 210 pharmacist-managed patients, mean time in therapeutic range was 67 percent compared to 48 percent in the physician-managed group. Major bleeding events occurred in 3.8 percent of pharmacist-managed versus 7.6 percent of physician-managed patients. Thromboembolic events were fewer in the pharmacist-managed group. Monitoring frequency was significantly higher and more regular in pharmacist-managed patients. Anticlot Treatment Scale satisfaction scores were significantly higher in the intervention group. These results provide strong empirical support for establishing pharmacist-managed warfarin clinics as the standard of care in Nigerian cardiology centres managing anticoagulation. Keywords: warfarin therapy, pharmacist-managed clinic, anticoagulation, Kano State, time in therapeutic range