Introduction: This study was chosen due to long waiting time at various
stages before doctors/ pharmacists saw patients at warfarin clinic. Objectives:
The objectives are to identify stages contributing to waiting time and to
assess efficacy of point-of-care testing (POCT) in reducing waiting time at
warfarin clinic. Methodology: This study was conducted in two phases. Phase 1 (pre
intervention) consisted of 171 patients attending warfarin clinic over three weeks
(06/04/2015-27/ 04/2015). Phase 2 (post intervention) consisted of 148 patients
(26/10/2014-09/11/2015). Patients with rejected INR samples and multiple
clinics on the same day were excluded. Data were analysed using SPSS 17. Results/Discussion:
171 patients were recruited in phase 1. 67.3% (115) Malays, 22.8% (39) Chinese,
9.4% (16) Indians and 0.6% (1) others. The mean age was 62.8 years. 54.4% (93) were
males compared to 45.6% (78) females. Significant waiting
time was from arrival of patient at venepuncture to blood taking which was 38.3
minutes ± 19.3, p < 0.001. Blood taken at venepuncture to sample arrive at
laboratory was 29.1 minutes ± 13.9, p < 0.001. The mean time to see
pharmacist was 44.2 minutes ± 24.5. The mean time to see doctor for both stable/deranged
INR was 58.7 ± 27.1, p < 0.001. Average 36.7 minutes ± 23.8 was spent at
doctor’s room, p < 0.001. Time spent from pharmacist receiving prescription
to warfarin dispensed was 16.3 ± 7.2, p < 0.001. Percentage of patients with
total waiting time in the post intervention study (arrival at venepuncture to
dispensing of warfarin) less than 180 minutes is 96.7% (compared to 21.6% in
the pre intervention group). The set standard is 80%. Causes contributing
towards excessive waiting time were delay in transporting samples to
laboratory, delay in blood taking at venepuncture, delay in sending results to
warfarin clinic and poor delegation of task between doctors/pharmacists. The signifycant
improvement in waiting time was attributed to the point-of-care testing (POCT)
device which avoided the need to send
samples to the laboratory. Conclusion: The point-of-care testing (POCT) system
provides a reliable and accurate alternative in monitoring patients on oral
anticoagulation therapy.
Cite this paper
Kasinathan, G. , Pairan, S. , Rowther, S. , Sulaiman, S. , Basimin, S. A. , Samsuni, N. and Balasegar, V. (2016). Efficacy of Point-of-Care Testing (POCT) in Reducing Total Waiting Time at Warfarin Clinic of a District Hospital: A Cohort Study. Open Access Library Journal, 3, e2428. doi: http://dx.doi.org/10.4236/oalib.1102428.
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