Objectives: This investigation characterizes the demographic characteristics
of the patients attending a pharmacist managed
anticoagulation clinic in the resource-constrained setting of western Kenya and
outlines the challenges of delivering an anticoagulation
monitoring service in this setting
Methods: Through the collaboration of Purdue University College of Pharmacy
faculty and local Kenyan pharmacists, a contextualized
anticoagulation clinic care model has been developed which incorporates
community health workers, pharmacy technologists, and
physicians to deliver protocol-based care. Through the collection of data on
standardized encounter forms, the initial demographic
characteristics of this population are described.
Results: The unique mix of indications for anticoagulant therapy of the 83
patients enrolled thus far can be seen as 9.6% have artificial
heart valves, 18.0% have rheumatic heart disease induced valvular changes, and
59.0% have deep vein thrombosis or pulmonary
embolism. Several setting specifi c challenges have been identifi ed including
the potential for drug interactions with warfarin due to
concomitant therapies for disease states such as tuberculosis and Human
Immunodefi ciency Virus (HIV).
Conclusions: With the increased awareness of the growing burden of diseases
requiring anticoagulation therapy in sub-Saharan
Africa, there is an emerging need for anticoagulation infrastructure in the
context of provision of health care in western Kenya.