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January 1, 2014World Journal of Cardiovascular DiseasesOpen Access

A bioanalyst-led management program for oral anticoagulation in elderly disabled patients achieved an average time in therapeutic range of 72%.

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Why the study?

Does a bioanalyst-led management program maintain high time in therapeutic range in elderly disabled patients on warfarin?

Population

579 elderly disabled patients in nursing home settings and domiciliary care receiving oral anticoagulation.

Design

Cohort

Key result

A bioanalyst-led management program for oral anticoagulation in elderly disabled patients achieved an average time in therapeutic range of 72%.

Authors

TVThomas VedtofteGMGitte Vedel MelsenLBLise Bathum

Discussion

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Member takes

Overview

May support bioanalyst-led warfarin programs in elderly disabled patients; leaves open need for randomized outcome trials.

Study Design

Type

Observational (n=579)

Multicenter

Yes

Structured PICO

Does a bioanalyst-led management program maintain high time in therapeutic range in elderly disabled patients on warfarin?

P
Population
579 elderly disabled patients (mean age 79.6 years, 61% female) in nursing home settings (~10%) and domiciliary care (~90%) receiving oral anticoagulation (warfarin).
I
Intervention
Bioanalyst-led management program for warfarin control, involving visiting nurses measuring INR with point-of-care testing and consulting a specially trained bioanalyst for dosage adjustments when out of therapeutic range.
O
Outcome
Time in therapeutic range (TTR)surrogate

A bioanalyst-led home management program for warfarin monitoring in elderly disabled patients achieved a high time in therapeutic range of 72%, comparable to specialized clinics.

Limitations

  • Minor bleeding episodes such as epistaxis were not recorded.
  • Exact frequency of fatal adverse effects could not be determined as most patients were not hospitalized in relation to their death.
  • Lack of a direct control group, relying on comparisons to previous publications.

Cite This Study

Vedtofte et al. (2014) conducted an observational in Oral anticoagulation treatment in elderly disabled patients (n=579). Bioanalyst-led management program was evaluated on Time in therapeutic range (TTR). A bioanalyst-led management program for oral anticoagulation in elderly disabled patients achieved an average time in therapeutic range of 72%.

synapsesocial.com/papers/6a1c1bc2666b677c61a92b4bhttps://doi.org/10.4236/wjcd.2014.412074
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Evaluation of time in therapeutic range among patients receiving warfarin therapy: A retrospective cohort study at one private hospital in Thailand2021
  2. 2Pharmaceutical Care Increases Time in Therapeutic Range of Patients With Poor Quality of Anticoagulation With Warfarin2018 · 25 citations
  3. 3ASSESSMENT OF TIME IN THERAPEUTIC RANGE WITH WARFARIN THERAPY IN PHARMACIST VERSUS USUAL CARE GROUP: A RETROSPECTIVE COHORT STUDY2020 · 1 citations
  4. 4Evaluation of a Pharmacist-Managed Anticoagulation Clinic2012
  5. 5Utility of TTR-INR guided warfarin adjustment protocol to improve time in therapeutic range in patients with atrial fibrillation receiving warfarin2024 · 7 citations