Prevention of Bleeding in Older Patients Taking Warfarin

Letters2 October 2001Prevention of Bleeding in Older Patients Taking WarfarinAlex C. Spyropoulos, MDAlex C. Spyropoulos, MDLovelace Health Systems; Albuquerque, NM 87108Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-135-7-200110020-00015 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:The well-designed study by Beyth and colleagues (1) showed that major bleeding events decreased significantly among older patients who received long-term oral anticoagulation through a multicomponent program that included patient self-testing, as compared with patients who received usual medical care prescribed by the treating physician. However, the study prompted the fundamental question of how this intervention would compare with what is rapidly becoming an important practice in many U.S. health care centers: nurse- or pharmacist-managed anticoagulation management services (AMS). The benefits of AMS over usual medical care, in terms of improved clinical outcomes (reduction in major bleeding ...References1. Beyth RJ, Quinn L, Landefeld C. A multicomponent intervention to prevent major bleeding complications in older patients receiving warfarin. A randomized, controlled trial. Ann Intern Med. 2000;133:687-95. [PMID: 11074901] LinkGoogle Scholar2. Gray DR, Garabedian-Ruffalo S, Chretien S. Cost-justification of a clinical pharmacist-managed anticoagulation clinic. Drug Intell Clin Pharm. 1985;19:575-80. [PMID: 3928310] CrossrefMedlineGoogle Scholar3. Wilt VM, Gums JG, Ahmed OI, Moore LM. Outcome analysis of a pharmacist-managed anticoagulation service. Pharmacotherapy. 1995;15:732-9. [PMID: 8602380] MedlineGoogle Scholar4. Chiquette E, Amato MG, Bussey HI. Comparison of an anticoagulation clinic with usual medical care: anticoagulation control, patient outcomes, and health care costs. Arch Intern Med. 1998;158:1641-7. [PMID: 9701098] CrossrefMedlineGoogle Scholar5. Samsa GP, Matchar DB, Goldstein LB, Bonito AJ, Lux LJ, Witter DM, et al . Quality of anticoagulation management among patients with atrial fibrillation: results of a review of medical records from 2 communities. Arch Intern Med. 2000;160:967-73. [PMID: 10761962] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Alex C. Spyropoulos, MDAffiliations: Lovelace Health Systems; Albuquerque, NM 87108 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoA Multicomponent Intervention To Prevent Major Bleeding Complications in Older Patients Receiving Warfarin Rebecca J. Beyth , Linda Quinn , and C. Seth Landefeld Metrics Cited byCurrent Awareness 2 October 2001Volume 135, Issue 7Page: 548KeywordsAnticoagulant therapyAnticoagulantsHealth careHemorrhageInternational normalized ratio ePublished: 2 October 2001 Issue Published: 2 October 2001 Copyright & PermissionsCopyright © 2001 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...