Safe and effective warfarin treatment requires individualized evaluation of bleeding risks and a therapeutic partnership with patients for ongoing management.
May support individualized bleeding risk assessment and patient partnership for warfarin; leaves open prospective trials to validate strategies.
There has been an exponential increase of warfarin usage in the community since several large and well-designed clinical trials have consistently found that warfarin can safely prevent embolic stroke in people with atrial fibrillation. Safe and effective warfarin treatment requires a case-by-case evaluation of each patient's clinical condition and risk factors for bleeding. It also demands a therapeutic partnership where patients can accept an educated responsibility for managing their own condition. This requires mutually understood plans for ongoing management, including dose adjustment and responses to under- or overdose and to bleeding complications.
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Alexander Gallus (1999) studied this question.
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