Coumadin/Anticoagulation Clinic

The Anticoagulation Clinic at Penn State Milton S. Hershey Medical Center opened in January 1998 and provides standardized care for over 1000 patients receiving outpatient anticoagulation. The goal of the Anticoagulation Clinic is to maximize the benefits of warfarin (Coumadin®) therapy yet avoid adverse effects. The Clinic makes appointments for blood tests and adjusts warfarin (Coumadin ®) doses as needed. Educational services about anticoagulation, possible interactions, and possible complications and side effects are also provided.

  • Elizabeth Bittner, B.S., RPh
  • Frank Herrmann, B.S., RPh
  • Paul Kocis, Pharm D.
  • Amy Leiby, RPh
  • Gretchen Richardson, Pharm D.
  • Deborah Connolly

What is Anticoagulation?
Anticoagulation is a term that describes the process of reducing clots from forming in the blood. Due to certain conditions such as atrial fibrillation, mechanical heart valves, previous deep vein thrombosis pulmonary embolism or or other forms of blood clots, many patients require the use of an anticoagulant. By "thinning the blood", the risk of developing future blood clots is reduced.

Who is Eligible to Use the Anticoagulation Clinic?
Patients are referred from either the inpatient service or the outpatient clinics. Currently, we accept new patients from Penn State Hershey Medical Center Cardiology, Vascular Services, Orthopedics, and Internal Medicine (UPC) services.

What Happens When I'm First Enrolled in the Program?
All patients meet with a pharmacist and are educated on the actions of warfarin (Coumadin ®), its side effects, and drug and dietary interactions. A dosing schedule is discussed and plans are made for how and where the patient will receive blood tests. All patients are also instructed on how to contact the Anticoagulation Clinic.

How Is My Therapy Monitored?
Warfarin (Coumadin) therapy is monitored by the use of blood samples to measure the Prothrombin Time (PT) and International Normalized Ratio (INR). The PT is a measure of how long it takes blood to clot. The INR is a ratio of the patient’s PT and a PT that is considered average for a patient not on anticoagulants. The target INR may be different for individual patients, depending upon the reason for taking warfarin (Coumadin ®).

The blood tests will be obtained on scheduled days. In the beginning, the PT/INR tests are scheduled more frequently, but as the therapy becomes more stable the time between blood tests lengthens. The dose of warfarin (Coumadin ®) is adjusted based on the results of the INR.

How Can I Find Out My Lab Results?
Patients have the option of two methods of blood testing. Patient can use their local laboratory (including the laboratory at Penn State Milton S. Hershey Medical Center in the University Physician's Center or Cherry Drive) and have blood drawn. The results are communicated to the clinic. Each patient is contacted by telephone within the next 36 hours and advised of the results. Dosing adjustments are then made over the phone, and the next follow-up appointment is made.

Patients may also use our "Point-of-Care" method. Patients can make a scheduled appointment with one of the pharmacists at our office in the University Physician Center, Suite 600. Appointments are scheduled every 20 minutes between 7:40 a.m. and 3:40 p.m., Monday through Friday. Blood testing is performed by "finger stick" (similar to blood glucose testing which patients with diabetes perform). The test results are immediate, thus our staff is able to review the results, discuss any outside factors affecting the results and make dosage recommendations before the patient leaves the clinic.

What Are The Clinic's Hours?
The Anticoagulation Clinic is located on the main campus of Penn State Milton S. Hershey Medical Center, University Physician's Center, Suite 600 and is open Monday through Friday (except holidays) from 8 a.m. to 5:00 p.m.  During these hours, educational visits and telephone follow-ups are made.  Patients or physicians may call at any time for questions related to warfarin (Coumadin ®) or their therapy.