Table 4.

Counseling Documentation

Variable	Pharmacist counseled n = 100	Standard of care n = 100	P-value
Learner specifieda	97	34	< 0.001
Patient	82	34	< 0.001
Family member	77	20	< 0.001
Other	1	0	0.014
Counseling method specifiedb	97	33	< 0.001
Verbal education	97	33	< 0.001
Written educational material	95	0	< 0.001
Language of written education material
Arabic	18	2	< 0.001
English	40	10	< 0.001
Not documented	42	88	< 0.001
Response of patient documented	100	33	< 0.001
Patient verbalized understanding	100	33	< 0.001
Patient needs reinforcement; re-evaluate education at another time	2	1	0.014
Instructions declined	1	0	0.014
Documented barriers to learning	65	33	< 0.001
Age-related	6	0	< 0.001
Cognitive	2	0	0.007
Emotional	1	0	0.014
Hearing	1	0	0.014
No Barrier	84	33	< 0.001
Elements of patient education
Rationale for therapy	92	5	< 0.001
Dosing	91	5	< 0.001
Monitoring	91	5	< 0.001
INR (for patients receiving Vitamin K antagonist)	33	2	< 0.001
Duration of therapy	82	5	< 0.001
Administration	92	5	< 0.001
Importance of compliance	94	5	< 0.001
Missed dose	91	5	< 0.001
Storage	88	5	< 0.001
Drug-drug interaction	88	5	< 0.001
Drug-food interaction	88	5	< 0.001
Signs and symptoms of bleeding	90	5	< 0.001
Reversal agent	32	2	< 0.001
Precautions	93	5	< 0.001
Patient communication with healthcare provider	41	1	< 0.001
Discharge medications documented in chart	94	84	0.024
Informed patient about next appointment date with physician	31	52	< 0.001
Time of next appointment (mean in days, +/− SD)	15.00 +/− 12.49	17.67 +/− 14.53	0.341

^a The values add up to more than 100% since more than one learner can exist for each counseling session (i.e. patient and family)

^b The values add up to more than 100% since more than one counseling method can be used in each counseling session (i.e. verbal education and written education material)