Chan Wai Hung Fredric. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2006. / Includes bibliographical references (leaves 67-72). / Abstracts in English and Chinese. / Acknowledgement --- p.i / Abstract --- p.ii / 摘要 --- p.iv / Table of contents --- p.vi / Publications --- p.ix / List of figures --- p.x / List of tables --- p.xi / Abbreviations --- p.xii / Chapter Chapter 1 --- Introduction / Chapter 1.1 --- Anticoagulation effect of warfarin --- p.2 / Chapter 1.2 --- Indications of warfarin therapy --- p.3 / Chapter 1.3 --- Monitoring systems for anticoagulation therapy --- p.4 / Chapter 1.4 --- Optimum target intensities for anticoagulation therapy --- p.5 / Chapter 1.5 --- Factors affecting anticoagulation effect of warfarin --- p.6 / Chapter 1.5.1 --- Drugs --- p.7 / Chapter 1.5.2 --- Diet --- p.8 / Chapter 1.5.3 --- Health supplements --- p.8 / Chapter 1.5.4 --- Comorbidities --- p.9 / Chapter 1.5.5 --- Genetic factors --- p.10 / Chapter 1.6 --- Management of anticoagulation therapy in Chinese patients --- p.11 / Chapter 1.7 --- Barriers to optimal INR control --- p.13 / Chapter 1.8 --- Two models of care for anticoagulation therapy - routine medical care and co-ordinated anticoagulation service --- p.14 / Chapter 1.9 --- Outcomes of two models of anticoagulation management --- p.14 / Chapter 1.9.1 --- Clinical outcomes --- p.14 / Chapter 1.9.2 --- Economic outcomes --- p.16 / Chapter 1.10 --- Clinical pharmacist involvement in the management of anticoagulation therapy --- p.17 / Chapter 1.11 --- Anticoagulation management in Hong Kong --- p.18 / Chapter 1.12 --- Hypothesis and objectives --- p.19 / Chapter Chapter 2 --- Materials and Methods / Chapter 2.1 --- Setting and subjects --- p.22 / Chapter 2.2 --- Interventions --- p.23 / Chapter 2.2.1 --- Newly proposed model --- p.23 / Chapter 2.2.1.1 --- Training of clinical pharmacist --- p.23 / Chapter 2.2.1.2 --- Development of management protocol --- p.24 / Chapter 2.2.1.3 --- Treatment algorithm of pharmacist-managed anticoagulation service --- p.25 / Chapter 2.2.1.4 --- Validation of the Coagucheck Pro DM --- p.28 / Chapter 2.2.2 --- Usual practice model --- p.29 / Chapter 2.3 --- Outcome measures --- p.29 / Chapter 2.3.1 --- Primary clinical outcomes --- p.29 / Chapter 2.3.1.1 --- Therapeutic and expanded therapeutic INR ranges --- p.29 / Chapter 2.3.1.2 --- A method to determine the amount of patient-time spent in each INR category --- p.30 / Chapter 2.3.2 --- Secondary clinical outcomes --- p.31 / Chapter 2.3.3 --- Economic outcomes --- p.32 / Chapter 2.3.4 --- Humanistic outcomes --- p.34 / Chapter 2.4 --- Sample size estimation --- p.34 / Chapter 2.5 --- Statistical analysis --- p.35 / Chapter Chapter 3 --- Results / Chapter 3.1. --- Patient demographics and indications --- p.37 / Chapter 3.2. --- Control of INR --- p.42 / Chapter 3.3. --- Incidence of major bleeding and thromboembolism --- p.44 / Chapter 3.4. --- Direct medical cost analysis --- p.46 / Chapter 3.5. --- Patient satisfaction --- p.48 / Chapter Chapter 4 --- Discussion and Conclusion / Chapter 4.1 --- Discussion --- p.51 / Chapter 4.1.1 --- Clinical outcomes of anticoagulation clinic --- p.52 / Chapter 4.1.2 --- Direct medical cost analysis --- p.56 / Chapter 4.1.3 --- Patient satisfaction --- p.59 / Chapter 4.1.4 --- Limitations --- p.62 / Chapter 4.1.5 --- Future studies --- p.63 / Chapter 4.2 --- Conclusion --- p.66 / References --- p.67 / Appendices / Appendix A. Management protocol --- p.73 / Appendix B. Data collection form --- p.96 / Appendix C. PSQ-18 --- p.104

Ho Toi Sze Joyce. / Thesis (M.Phil.)--Chinese University of Hong Kong, 2005. / Includes bibliographical references (leaves 65-74). / Abstracts in English and Chinese. / Acknowledgement --- p.ii / Contents --- p.iii / Abstract --- p.viii / List of Abbreviations --- p.xvii / List of Tables --- p.xix / List of Figures --- p.xx / Chapter Chapter 1 --- Introduction --- p.1 / Chapter 1.1 --- The role of Non-steroidal anti-inflammatory drugs (NSAIDs) --- p.1 / Chapter 1.2 --- NSAID-induced gastrointestinal (GI) toxicity --- p.1 / Chapter 1.2.1 --- Pathogenesis of NSAID-induced GI toxicity --- p.2 / Chapter 1.2.2 --- GI symptoms --- p.4 / Chapter 1.2.3 --- GI ulcers --- p.4 / Chapter 1.2.4 --- GI complications --- p.5 / Chapter 1.2.5 --- Risk factor for GI complications --- p.6 / Chapter 1.2.6 --- Ulcerogenicity of different NSAIDs in upper GI events --- p.6 / Chapter 1.3 --- Prevention of NSAID-induced GI toxicity --- p.7 / Chapter 1.3.1 --- H2-receptor antagonists --- p.8 / Chapter 1.3.2 --- Misoprostol --- p.8 / Chapter 1.3.3 --- Proton Pump Inhibitor (PPI) --- p.9 / Chapter 1.3.4 --- Selective COX-2 Inhibitors --- p.10 / Chapter 1.3.4.1 --- GI safety of selective COX-2 inhibitors --- p.11 / Chapter 1.3.4.1.1 --- Gastrointestinal outcomes research of rofecoxib --- p.13 / Chapter 1.3.4.1.2 --- Celecoxib Long term Arthritis Safety Study --- p.14 / Chapter 1.3.4.2 --- Cardiovascular toxicity of NSAIDs --- p.15 / Chapter 1.3.4.2.1 --- Cardiovascular toxicity of non-selective NSAIDs --- p.15 / Chapter 1.3.4.2.2 --- Cardiovascular toxicity of selective COX-2 inhibitors --- p.16 / Chapter 1.4 --- Guidelines on the management of osteoarthritis (OA) and rheumatoid arthritis (RA) --- p.21 / Chapter 1.4.1 --- American College of Rheumatology (ACR) Subcommittee --- p.22 / Chapter 1.4.2 --- National Institute for Clinical Excellence (NICE) --- p.23 / Chapter 1.4.3 --- Hong Kong Hospital Authority (HA) --- p.23 / Chapter 1.5 --- Cost of illness of upper GI events in the setting of an emergency room of a regional hospital in Hong Kong and cost analysis of selective COX-2 inhibitor with non-selective NSAID plus gastroprotective agent --- p.24 / Chapter 1.6 --- Objectives --- p.25 / Chapter Chapter 2 --- Cost of illness of upper GI events in the setting of an emergency room of a regional hospital in Hong Kong --- p.26 / Chapter 2.1 --- Methods --- p.28 / Chapter 2.1.1 --- Study site --- p.28 / Chapter 2.1.2 --- Cohort participants --- p.28 / Chapter 2.1.3 --- Resource data collection --- p.29 / Chapter 2.1.4 --- Cost data --- p.30 / Chapter 2.1.5 --- Statistical Methods --- p.31 / Chapter 2.1.6 --- Study perspective --- p.31 / Chapter 2.2 --- Results --- p.31 / Chapter 2.2.1 --- Demographic data --- p.31 / Chapter 2.2.2 --- Total direct medical cost of upper GI complaints in UCH --- p.33 / Chapter 2.3 --- Discussion --- p.35 / Chapter 2.3.1 --- Total direct medical cost of upper GI events --- p.35 / Chapter 2.3.2 --- Cost of upper GI events associated with NSAID usage --- p.38 / Chapter 2.3.3 --- Low dose aspirin on NSAID-induced GI toxicity --- p.38 / Chapter 2.3.4 --- Limitation --- p.39 / Chapter 2.3.5 --- Future study --- p.41 / Chapter 2.4 --- Conclusion --- p.41 / Chapter Chapter 3 --- Cost analysis of selective COX-2 inhibitor versus non-selective NSAID with gastroprotective agent --- p.43 / Chapter 3.1 --- Methods --- p.46 / Chapter 3.1.1 --- Local randomized clinical trial --- p.46 / Chapter 3.1.1.1 --- Study population --- p.46 / Chapter 3.1.1.2 --- Cost data --- p.47 / Chapter 3.1.1.3 --- Statistical Methods --- p.48 / Chapter 3.1.1.4 --- Sensitivity analysis --- p.49 / Chapter 3.1.2 --- Large randomized clinical trial --- p.49 / Chapter 3.1.2.1 --- Study population --- p.49 / Chapter 3.1.2.2 --- Cost data --- p.50 / Chapter 3.2 --- Results --- p.50 / Chapter 3.2.1 --- Local randomized clinical trial --- p.51 / Chapter 3.2.1.1 --- Demographic data --- p.51 / Chapter 3.2.1.2 --- Cost analysis --- p.52 / Chapter 3.2.1.3 --- Sensitivity analysis --- p.53 / Chapter 3.2.2 --- Large randomized clinical trial --- p.54 / Chapter 3.2.2.1 --- Demographic data --- p.54 / Chapter 3.2.2.2 --- Cost analysis --- p.55 / Chapter 3.3 --- Discussion --- p.55 / Chapter 3.3.1 --- Cost analysis --- p.55 / Chapter 3.3.2 --- Sensitivity analysis --- p.59 / Chapter 3.3.3 --- Low dose aspirin on NSAID-induced GI toxicity --- p.59 / Chapter 3.3.4 --- Limitation --- p.60 / Chapter 3.4 --- Future study --- p.62 / Chapter 3.5 --- Conclusion --- p.62 / Chapter Chapter 4 --- Conclusion --- p.63 / Chapter Chapter 5 --- Reference --- p.65 / Appendix Data collection form --- p.75