CPAMS: Information for Healthcare Professionals
The Community Pharmacy Anticoagulation Management Service (CPAMS) provides international normalised ratio (INR) testing and dose adjustments for patients prescribed warfarin.
An accredited CPAMS pharmacist provides this service, which is free for patients, where funded by their District Health Board (DHB).
The service involves pharmacists providing point of care testing and adjustment of warfarin doses with the aid of a decision support system (INR Online) and a standing order from a general practitioner (GP).
This information is intended for healthcare professionals. If you are a patient, please see Information for patients.
How are patients enrolled into the service?
A GP refers eligible patients prescribed warfarin into the service. Only patients for whom their GP has signed the standing order may be enrolled into the service.
Benefits of the service
Instead of going to the laboratory for a venous blood test, an accredited CPAMS pharmacist can measure INR levels using just a small sample of blood from a gentle finger prick.
The test results are available immediately, which means the pharmacist can modify the warfarin dose straight away, without delay.
There is no need to phone patients with their test results, thus freeing up GP and practice staff time.
- “I am pleased that my pharmacy can offer this service as it was a pain going to the labs and then waiting for the nurse or doctor to call me. This is instant.”
- “It doesn’t hurt as much, just a finger prick.”
- “I understand my warfarin management and what INR means for me.”
- “Great that you are working together with my GP.”
Quality of care
CPAMS has been running in New Zealand for 10 years. The first pilot was run in 2010 and now over 6000 patients are regularly managed using this service.
INR Online have carried out a review to see if the high level of anticoagulant control achieved during the original pilot is still maintained. The results show that control has remained consistently high with the time in the therapeutic range over 70% for the last 5 years.
The full report can be found here – CPAMS at 10 years.
Another study has shown CPAMS provides safe reliable anticoagulant care, with patients experiencing a consistently high level of Time in Therapeutic Range (TTR).
How CPAMS is being delivered?
View the latest 'National CPAMS Quality Report' on the TAS website which details how community pharmacies are delivering the service.
The report uses INR Online (software provider) data to show quality measures of care based on the number of bleeds, Time in Therapeutic Range (TTR) and timeliness of testing.
Pharmacies are responsible for having a quality assurance programme that ensures the device measuring INR is providing reliable results. Each CPAMS provider is required to undertake the quality assurance requirements as set out in the service specifications.