Community Pharmacy Anti-Coagulation Management Service
In December 2010 a Community Pharmacy Anti-Coagulation Management (CPAMS) Service was piloted in community pharmacies throughout New Zealand. The CPAM Service uses international normalised ratio (INR) point-of-care testing and adjusts warfarin doses with the aid of a decision support system in the pharmacy.
After a successful evaluation of the pilot by the University of Auckland it was agreed to expand the CPAM Service under the new Community Pharmacy Service Agreement.
GPs who worked with the pharmacies in the pilot project were supportive of the outcomes. Reports included more favorable outcomes for patients, with the immediacy of results leading to improved compliance.
The CPAM Service is an integrated care model providing an excellent example of the pharmacist and GP working collaboratively for the benefit of the patient, and as integral members of the primary health care team. This greater emphasis on the multi-disciplinary health team is a key strategic goal of the new community pharmacy service model.
There are now 158 community pharmacies now providing CPAMS with over 6000 patients currently working directly with their local pharmacist to manage their warfarin levels.
DHBs are facilitating training courses to provide appropriate training for recent providers.
View the latest national CPAMS Quality Report to see how community pharmacies are delivering the Service. The Report uses INR Online (software provider) data so show quality measures of care based on:
- The number of bleeds
- Time in Therapeutic Range (TTR)
- Timeliness of testing
A pharmacy specific report based on the same quality measures of care is available so you can compare and self assess your pharmacy's service delivery. This is available from DHB Portfolio Manager.
We encourage pharmacies to keep a copy of the definitions to hand when viewing their own data and the Report. The definitions explain the method used to calculate the results and information in the Report.
If you are a General Practitioner working to support your patients manage this INR levels through their community pharmacy, the evidence in the Report may help support your clinical judgements about CPAMS and whether it is right for you and your patients.
|National Quality Report January - June 2016|
|National Quality Report July - December 2015|
Below are some frequently asked questions about the Report.
If you are currently prescribed warfarin and are interested in learning more about the service please contact your GP.
If you are a pharmacy owner you can contact your DHB Portfolio Manager for more information.
What should you do with this data?
Pharmacy owners should use it to self assess the level of service delivery they provide and the areas that could be developed.
Information can be shared by pharmacy with local GPs as it provides evidence to support their clinical judgments about the Service and the benefits for service users.
How often will this Report be updated?
Every six months and the latest version will be made available on this webpage.
Below are a series of key documents that all CPAMS providers need to be aware of before they begin providing the service.
Resources for pharmacists working with patients
|CPAMS fact sheet for patients|
|Suggestions for getting started|
|CPAMS fact sheet for primary & community care|
|Patient registration and consent form|
|CPAMS case studies|
|Letter to patients - template for pharmacists|
Information to help pharmacists get started with CPAMS
Learn more about how patients learning to manage their INR levels and improve their overall health as a result of the support they receive from their community pharmacy as part of this service by reading the CPAMS Case Studies .
Additional CPAMS information is available for General Practitioners on the Prescriber page.