What question did this study set out to answer?

To identify clinical and demographic factors associated with anticoagulation stability and evaluate if stable patients can be safely monitored at extended intervals.

July 8, 1989Pharmacotherapy The Journal of Human Pharmacology and Drug Therapy

Evaluation of Factors Associated with Stability of Anticoagulation Therapy

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Why the study?

What factors are associated with the stability of long-term warfarin therapy and the probability of requiring a dosage change?

Population

82 patients receiving long-term warfarin therapy

Design

Cohort

Follow-up

199.34 patient-years (total)

Authors

RRRaylene M. RospondManchester University CQChristine M. QuandtThe University of Texas Health Science Center at San Antonio GCGary M. ClarkDana-Farber Brigham Cancer Center

Discussion

Member takes

Implication

May support extending warfarin monitoring intervals after 2 months of stability; leaves open prospective validation before practice change.

Key Points

To identify clinical and demographic factors associated with anticoagulation stability and evaluate if stable patients can be safely monitored at extended intervals.
Analyzed 199.34 patient-years of follow-up data from 82 patients receiving long-term warfarin therapy.
Categorized patients into stable (n = 67) and unstable (n = 15) anticoagulation cohorts.
Evaluated patient demographics, medical history, concurrent therapies, and the timing of required dosage changes over follow-up.
Most baseline demographics and medical histories did not distinguish stable from unstable patients, though unstable patients trended younger (p = 0.13).
Among stable patients, a diagnosis of deep vein thrombosis or pulmonary embolism, or elevated alanine aminotransferase levels, significantly increased the likelihood of requiring a dosage adjustment.
The probability of needing a dosage change at monthly visits inversely correlated with stability duration, declining from ~16% at initial monthly monitoring to <8% after 2 months of stability.

Structured PICO

What factors are associated with the stability of long-term warfarin therapy and the probability of requiring a dosage change?

Population

82 patients receiving long-term warfarin therapy

Intervention

Long-term warfarin therapy

Outcome

Stability of anticoagulation (probability of requiring a dosage change)surrogate

The probability of requiring a warfarin dosage change decreases as the duration of stable anticoagulation increases, suggesting monitoring intervals could be safely extended in long-term stable patients.

Cite This Study

Rospond et al. (1989) studied this question.

synapsesocial.com/papers/6a767f88f91c041860c44c0a https://doi.org/10.1002/j.1875-9114.1989.tb04127.x

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Implication

May support extending warfarin monitoring intervals after 2 months of stability; leaves open prospective validation before practice change.

Evaluation of Factors Associated with Stability of Anticoagulation Therapy

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Evaluation of Factors Associated with Stability of Anticoagulation Therapy

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider