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Anticoagulation management

Treatment and prevention of blood clots


Anticoagulation is the treatment and prevention of blood clots. These clots can block blood flow to important areas of the body such as the heart, brain, lungs or limbs. An anticoagulant is often prescribed to treat people with blood clots in the legs and lungs, atrial fibrillation or after heart-valve replacement surgery.

The most common anticoagulant prescribed is warfarin, also known as Coumadin®. MultiCare clinics also have experience dosing other anticoagulants such as low molecular weight heparins.

Centers of Excellence

Centers of Excellence

All of our Pharmaceutical Resource Clinics are designated Anticoagulation Centers of Excellence by the Anticoagulation Forum.

Participation in this program demonstrates our ongoing pursuit to achieve the highest level of care and the best possible outcomes for our patients.

There are only five other organizations in Washington State with this designation.

How we help

Your physician will need to complete a referral for you to be seen at one of MultiCare’s Pharmaceutical Resource Clinics. You will be contacted by the clinic staff to schedule an initial appointment.

At each visit, you will see a pharmacist experienced in anticoagulation treatment. The pharmacist will:

  • Measure your INR (International Normalized Ratio). This is done using a point-of-care meter that requires a small amount of blood from your finger. Accurate results are provided within minutes.
  • Assess changes in your health, diet, medications and activities since these can affect warfarin.
  • Make warfarin dose adjustments at the visit, if necessary. Verbal and written instruction of your warfarin dosage is provided.
  • Provide important information related to warfarin including medication and food interactions, side effects and warning signs.
  • Authorize prescription refills for warfarin, if necessary.
  • Address any concerns or questions regarding warfarin therapy.

Your first appointment may last 45 minutes. Comprehensive education is provided during the initial visit. Follow-up appointments take about 15 minutes. The INR will be checked about every four to six weeks, and more often when you first begin therapy.

Are you a good candidate for Home INR Monitoring?

Warfarin therapy must be closely monitored to ensure that patients are on the right dose. In the past, this meant monthly trips to the Pharmaceutical Resource Clinic for blood work. MultiCare is now offering an easier solution for patients. Patients can test their INR at home with a small, easy-to-use meter, rather than coming in monthly to the clinic. Pharmaceutical Resource Clinics will provide you with a meter, test strips, and all the necessary supplies so you can monitor your anticoagulation therapy at home. You will receive face-to-face training with a Pharmaceutical Resource Clinic specialist who is either a pharmacist or nurse. After you are trained, you will call or email us through MyChart your INR results every week. We will work with you to make any necessary dosing adjustments.

How does Home INR Monitoring work?

  • Find out if you are a good candidate: Talk with your Pharmaceutical Resource Clinic to find out if you are a good candidate. We will help decide whether this option is right for you.
  • Your doctor writes a prescription: If you have been identified as a good candidate for Home INR Monitoring, the Pharmaceutical Resource Clinic will need to obtain a referral and prescription for a meter from your doctor.
  • Check with your insurance: Our Pharmaceutical Resource Clinic will check with your insurance provider to see if this service is covered and how much it will cost. We will let you know the cost before you decide to participate.
  • Receive training on the monitor: After you are trained on how to use the monitor, you can start testing your INR at home.
  • Stay connected with Pharmaceutical Resource Clinic specialists: You will report your INR test weekly to the Pharmaceutical Resource Clinic and we will provide dosing instructions based on your results.

If you can answer YES to all the questions below, you likely are a good candidate and you should discuss this option with your Pharmaceutical Resource Clinic provider.

  1. Do you take warfarin or a brand of warfarin such as Coumadin or Jantoven, and plan to take it long term?
  2. Do you want to have greater control and stabilization of your INR?
  3. Would it be convenient for you to report your results via phone call or MyChart to the Pharmaceutical Resource Clinic?
  4. Could you thoroughly follow instructions from our Pharmaceutical Resource Clinic specialists?
  5. Are you physically capable of performing a test by taking a fingerstick blood sample, or do you have a caregiver that could assist you?

Benefits of using MultiCare Pharmaceutical Resource Clinics

There are many reasons to choose MultiCare Pharmaceutical Resource Clinics:

  • Studies have shown outpatient anticoagulation clinics can provide better anticoagulation control.
  • The clinic is staffed by pharmacists who have extensive experience in anticoagulation therapy.
  • INR is tested with a simple fingerstick and results are available in minutes which eliminates painful blood work, and the longer wait times for lab results.
  • Pharmacists interpret your INR and determine immediately if any dosage changes are needed before you leave the clinic.
  • You will receive individualized patient education and counseling to help meet your needs
  • Family members and/or caregivers can be included in the visits.
  • All documentation is done electronically, which gives MultiCare providers directly involved in your care access to the results.

Contract of care

We will follow your care closely but you need to take the responsibility to follow exact instructions for drug dosing. It is important to notify the clinic if you have had a recent visit to the Emergency Department, been hospitalized, started a new medication or had any diet changes.

If you are unable to keep your appointment, please notify the office to reschedule. Failure to keep your appointments or to follow any of the instructions given to you could result in serious health risks and/or termination from the program. Please notify the clinic if your telephone number changes.


Tacoma Pharmaceutical Resource Clinic
1901 S Union Ave, Bldg B, Suite #7009
Phone: 253-459-6736
Fax: 253-459-6238
Open: Mon-Fri, 8am-4:30pm (closed 12-1:15pm for lunch)

Auburn Pharmaceutical Resource Clinic
Auburn Medical Center – Plaza One
202 N. Division St. Suite #401
Phone: 253-545-2550
Fax: 253-804-2871
Open: Mon-Fri, 8am-4:30pm

Gig Harbor Pharmaceutical Resource Clinic
4545 Point Fosdick Drive NW, Suite #260
Gig Harbor
Phone: 253-372-6996
Fax: 253-530-8163
Open: Mon-Wed & Fri, ;8am-4pm. Closed 12-1pm

Puyallup Pharmaceutical Resource Clinic
1322 3rd St. SE, Suite #020
Phone: 253-697-1350
Fax: 253-770-5175
Open: Mon-Wed, Fri, 8:30am-5pm, Thurs, 7:30-4pm, Closed 12-1pm