Clinical Pharmacist Involved in the Integrated Pharmaceutical Care of Anticoagulant Treatment of a Perinatal Pulmonary Embolism Patient with Warfarin and Aspirin

OBJECTIVE To investigate the role of clinical pharmacists in the individualized anticoagulant therapy and anticoagulant management of patients with perinatal pulmonary embolism with warfarin and aspirin. METHODS Clinical pharmacist participated in the formulation of anticoagulant treatment and medication plan of one perinatal pulmonary embolism patient in the department of cardiovascular medicine, with the anticoagulant guidance and follow-up after discharge. RESULTS According to the warfarin gene test, the clinical pharmacist carried out individual anticoagulation adjustment on the patient, and followed up for 8 months after discharge, during which aspirin enteric-coated tablets were added with the consent of the doctors, but the INR of the patient still failed to meet the standard. In order to avoid the occurrence of thrombus events, the enteric-coated tablets was replaced with dabigatran ester the thrombus disappeared after 2 months of administration. No serious bleeding or thromboembolic adverse events occurred during anticoagulation. CONCLUSION Clinical pharmacists carry out whole-process anticoagulation management for patients in hospital and after discharge to provide reference for clinical pharmacists in the exploration of pharmaceutical care model, and reflect the positive role of clinical pharmacists in patients' drug treatment team.