1. Warfarin-Specific Medication Charts Do they have a place in Aged Care Facilities? Margaret Jordan a,b Judy Mullan a, Victoria Traynor a a. University of Wollongong; b. Illawarra Division of General Practice Introduction The quality use of all medications and particularly warfarin is difficult to achieve in residential aged care facilities 1,2,3,4. Based on recommendations from previous research conducted by the researchers a standardised warfarin-specific medication chart (Fig 1) was developed. Aims To evaluate the acceptability, usability and safety implications of the new strategy, which involved the introduction and education about the warfarin-specific medication chart for prescribing and managing warfarin therapy for Illawarra based RACF residents. Methods A mixed-methods approach using a pre-test/post-test with intervention design was used in the study (Fig 2). Descriptive statistics were used to assess the quantitative aspects of the study, while thematic analysis was used to assess the qualitative aspects of the study. Setting and study participants: Three residential aged care facilities 23 RACF residents receiving warfarin 9 GPs prescribing warfarin to the RACF residents 25 nurses responsible for managing the warfarin for the RACF residents Results Cont….. Figure 1 Warfarin Specific Medication Chart Figure 2 : Flow Chart of Study Methods ParticipantsRACFNo. of *GPs prescribing warfarin in each RACF Total no. of RACF residents prescribed warfarin in study period A59 B35 C69 Total3923 * GPs visited,ore than 1 RACF Resident Co-Morbid Conditions Resident Concurrent medications used with warfarin Mean 8.3Mean 9 Range 3-15Range 2-16 Results Table 1 : RACF, GP & RACF Resident Participants Figure 3 : Warfarin indications for RACF residents Table 2 : Co-Morbid & Concurrent Medications for RACF residents Key Qualitative Themes 1.more accurate documentation which potentially reduces warfarin related errors & improves safety 2.recognition & formalisation of GP & RN roles in warfarin management 3.time saving & improved work flow Discussion & Conclusion The new warfarin management strategy was evaluated as being acceptable and easy to use, as well as providing important decision-support to improve warfarin prescribing, monitoring and administration in RACFs. Figure 4: Documentation of residents warfarin indication and target INR details. Figure 5: Phase 3 - GP responses Figure 6: Phase 3 – Nurse responses (1) Gallus, A., 1999, Towards the safe use of warfarin: An overview, Journal of Quality in Clinical Practice, 19, pp:55-59; (2) Ansell et al., 2011, Managing oral anticoagulant therapy, Chest, 119, pp:22s-38s; (3) Fang et al., 2004, Advanced age, anticoagulation intensity, and risk for intracranial haemorrhage among patients taking warfarin for atrial fibrillation, Ann Intern Med, 141, pp:745-752; (4) Gurwitz et al., 2007, The safety of warfarin therapy in the nursing home setting, The American Journal of Medicine, 120 (6), pp:539-544. The findings of the study were highly promising and demonstrated usability, acceptance and potential safety implications of the new strategy. The main findings are summarised in Tables 1-2, Figures 3-6 and Key Qualitative themes.