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January 8, 2026Annals of Pharmacotherapy

Evaluation and Optimization of INR Goals in Patients With Mechanical Aortic Valves in a Pharmacist-Run Clinic: An Anticoagulation Stewardship Initiative

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Key result

29.3% of patients with mechanical aortic valves had INR goals inconsistent with guidelines, with pharmacist recommendations accepted in 87% of cases.

Authors

BWBarbara WangMHMadison HubertMSMalgorzata Symons

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Overview

Quality improvement initiative assesses INR goals in patients with mechanical aortic valves, suggesting important adjustments.

Key Points

  • This research aims to evaluate INR goal appropriateness in patients with mechanical aortic valves and identify pharmacist intervention opportunities.
  • Cross-sectional quality improvement study conducted at an outpatient anticoagulation clinic.
  • Included adult patients with isolated mechanical AVR managed on warfarin.
  • Pharmacists evaluated INR goals based on clinical context and guidelines.
  • Recommendations for INR goal adjustments were made to referring providers.
  • Of 100 patients, 81 met eligibility criteria for the analysis.
  • 29.3% had INR goals inconsistent with current guidelines.
  • Pharmacist-led outreach led to 87% acceptance of goal adjustment recommendations.
  • Recommendations often involved adjusting INR targets based on thromboembolic risk factors.

Cite This Study

Wang et al. (2025) studied this question. 29.3% of patients with mechanical aortic valves had INR goals inconsistent with guidelines, with pharmacist recommendations accepted in 87% of cases.

synapsesocial.com/papers/6960877dfa51ca23bb9809echttps://doi.org/10.1177/10600280251399028
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Anticoagulation therapeutic ranges and clinical outcomes in patients with a mechanical heart valve treated with vitamin K antagonists2026
  2. 2Quality of anticoagulation and outcomes after mechanical aortic valve replacement in patients with atrial fibrillation: a nationwide cohort study2023
  3. 3Determinants of Suboptimal INR Control in Eritrean Post–Cardiac Surgery Patients: Insights from a Low-Resource Setting2026
  4. 4Evaluating Long-Term Results: Anticoagulation Challenges and Quality of Life in Pakistani Patients with Mechanical Heart Valve2025
  5. 5Enhancing adherence to guideline-directed use of anticoagulant therapy in atrial fibrillation: a triad of quality improvement interventions in an academic outpatient setting2026