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  5. Physician Managed warfarin Clinic Expectations and
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Exit Survey
 
 
You are invited to participate in our survey regarding your expectation and acceptance towards pharmacist managing your warfarin. All people attending hamad general hospital warfarin clinic "as patients" will be asked to complete the questionnaire. It will take approximately five minutes to complete the questionnaire.

Your participation in this study is completely voluntary. There are no foreseeable risks associated with this project. However, if you feel uncomfortable answering any questions, you can withdraw from the survey at any point. It is very important for us to learn your opinions.Your survey responses will be strictly anonymous.
And any personal information will be coded and kept confidential, it will be use only to assure validity and reliability of our study.
If you agreed and provided your contact number or email, we might contact you for further expanding of our research.
Thank you very much for your time and support.

 
 
 
 
What is your gender?
 
Male
 
Female
 
 
What is your age?
 
18-29
 
30-49
 
50-69
 
70 or older
 
 
How many appointments did you attend in this clinic (counting this one)?
 
First appointment
 
Two appointments
 
Three or more appointments
 
If this is your third appointment or more
Strongly Disagree Disagree Undecided Agree Strongly Agree N/A
Your INR (blood thickness measure) is within target
You experienced bleeding event that needed emergency visit
You had drug interaction that affect your INR
 
Considering your past interaction with pharmacists,
Pharmacists are qualified to run Warfarin clinic because
Strongly disagree Disagree Neutral Agree Strongly agree
Pharmacist knowledge regarding your medication
Pharmacist usage of understandable language
Pharmacist commitment to answer drug related questions
Pharmacist ability to educate regarding side effect
Pharmacist ability to educate regarding need of medication
Pharmacist ability to educate regarding drug interaction
Pharmacist ability to educate regarding food interaction
Pharmacist empathy and appreciation of your therapy concerns
 
Considering Pharmacist Managed Warfarin Clinic, What do you expect
Strongly disagree Disagree Neutral Agree Strongly agree
You will save time
Your blood thickness will be better within the target value
There will be less drug interaction chance
You will have better environment to discuss medication
There will be less warfarin dosing errors
 
 
What other benefits you expect you could gain if followed on Pharmacist Managed Warfarin Clinic?
   
 
 
What are your concerns regarding Pharmacist Managed Warfarin Clinic?
   
 
 
Over all, do you agree to be referred to Pharmacist Managed Warfarin Clinic?
 
Yes
 
No