Background: Anticoagulation therapy with vitamin K antagonists requires vigilant monitoring to maintain the International Normalized Ratio (INR) within the therapeutic range. Inconsistent monitoring and lack of patient education often result in suboptimal control and adverse events. Structured Anticoagulation Clinics (ACCs) are designed to enhance therapeutic safety and patient outcomes through systematic follow-up, education, and counselling. This study aimed to assess the impact of an Anticoagulation Clinic intervention on therapeutic control and patient-centred outcomes in a tertiary care hospital.

Methods: A pre–post interventional study was conducted among 139 adult patients receiving oral anticoagulation therapy for various indications including atrial fibrillation, mechanical heart valves, and venous thromboembolism. Baseline data were collected before establishment of the Anticoagulation Clinic and compared with post-intervention data after six months of structured clinic follow-up. Primary outcomes included Time in Therapeutic Range (TTR) and INR stability. Secondary outcomes comprised adverse events, medication adherence (MMAS-8), patient satisfaction (Duke Anticoagulation Satisfaction Scale — DASS), and knowledge regarding anticoagulation. Paired t-tests and McNemar tests were applied as appropriate.

Results: The mean age of participants was 52.4 ± 13.6 years, with 59% males. Following clinic intervention, the mean TTR significantly improved from 41.6 ± 18.1% to 65.0 ± 17.1% (p < 0.001), and the proportion achieving TTR ≥ 65% increased from 10.1% to 48.2% (p < 0.001). Major bleeding events decreased from 8.6% to 2.2% (p = 0.022), while overall adverse events reduced from 23.0% to 10.1% (p < 0.01). Medication adherence (MMAS-8) improved from 4.92 ± 1.51 to 6.25 ± 1.14 (p < 0.001), and patient satisfaction scores (DASS) improved from 59.2 ± 13.8 to 42.3 ± 11.2 (p < 0.001). Knowledge scores rose markedly from 3.79 ± 1.87 to 6.81 ± 1.78 (p < 0.001), with adequate knowledge increasing from 6.5% to 69.1%. No significant correlations were found between post-intervention TTR and adherence, satisfaction, or knowledge scores.

Conclusion: Implementation of a structured Anticoagulation Clinic significantly improved therapeutic control, reduced adverse events, and enhanced adherence, satisfaction, and patient knowledge. The findings support the integration of dedicated anticoagulation services within tertiary hospitals to optimize patient-centred outcomes and ensure safer long-term anticoagulation therapy.