Key result
Warfarin use in the elderly for stroke prevention requires careful patient selection, low-dose initiation, thorough education, and close monitoring to balance benefits against adverse outcome risks.
Warfarin therapy in the elderly requires careful management, including low-dose initiation and close monitoring, to mitigate the high risk of adverse outcomes.
Warrants cautious warfarin management in elderly; leaves open optimal protocols via prospective trials.
The use of warfarin in the elderly, particularly for stroke prevention in chronic atrial fibrillation, is steadily increasing. Although the benefits of warfarin are greatest in the elderly, so are the risk of adverse outcomes and the difficulties of anticoagulant management. Clinical systems need to improve to counter this therapeutic dilemma, as warfarin is likely to remain the only widely available oral anticoagulant for the foreseeable future. Aspects that require attention are: the careful selection of patients in whom treatment with warfarin is appropriate; initiating therapy in a low dose (e.g., 2.5-5 mg/day); thorough education of patients and carers; close monitoring, especially with any change in the patient's regular drug therapy; involving patients more in the management of their warfarin therapy (self-monitoring/management in suitable patients); and ongoing review of the appropriateness of therapy as circumstances change.
No takes yet. Share an insight, caveat, or question.
Bereznicki et al. (2006) conducted a review in chronic atrial fibrillation in the elderly. warfarin was evaluated. Warfarin use in the elderly for stroke prevention requires careful patient selection, low-dose initiation, thorough education, and close monitoring to balance benefits against adverse outcome risks.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: