What question did this study set out to answer?

To describe the operational structure, laboratory monitoring protocols, and clinical outcomes of a specialized anticoagulation clinic.

January 1, 1995Thrombosis and Haemostasis

Clinical Coagulation Laboratory and Oral Anticoagulant Therapy Treatment. Instrumentation and Methodology

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Why the study?

Does management in a specialized anticoagulation clinic provide effective INR control and low rates of adverse events in patients on oral anticoagulants?

Population

1,068 patients managed at an anticoagulation clinic in 1994

Design

Cohort

Follow-up

1 year

Authors

TBT BarbuiUniversity of Bergamo GFGuido FinazziIstituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia Romagna "Bruno Ubertini"ARAndrea RemuzziUniversity of Bergamo

Discussion

Member takes

Implication

Specialized clinics may support high TTR with low events; leaves open confirmation versus usual care in randomized trials.

Key Points

To describe the operational structure, laboratory monitoring protocols, and clinical outcomes of a specialized anticoagulation clinic.
Evaluated 1,068 patients (572 males, 496 females; median age 63, range 6–91 years; 74% long-term prophylaxis) managed in 1994 at a dedicated clinic staffed by a physician, two nurses, and a technician.
Measured prothrombin time using sensitive thromboplastin (ISI < 1.1) alongside automated software for INR calculation, tracking, and dosage prescription.
Assessed quality of anticoagulation control using cumulative INR, last check in file, and linear change methodologies.
Therapeutic range targets were met across 69% of laboratory tests (cumulative INR), 71% of patients (last check), and 80% of treatment duration (linear change).
Observed clinical complication rates were 0.2% for thrombosis, 0.2% for major bleeding, and 12.5% for total bleeding events.

Structured PICO

Does management in a specialized anticoagulation clinic provide effective INR control and low rates of adverse events in patients on oral anticoagulants?

Population

1,068 patients managed at an anticoagulation clinic in 1994 (median age 63, 572 male / 496 female, 74% on long-term prophylaxis)

Intervention

Management by a specialized anticoagulation clinic utilizing sensitive thromboplastin (ISI < 1.1) and a computer program for INR calculation, therapeutic range comparison, and automatic dosage prescription

Outcome

Laboratory quality of therapy (percentage of controls, patients, and days within therapeutic range) and clinical outcomes (rates of thrombosis, major bleeding, and total bleeding)surrogate

A specialized anticoagulation clinic utilizing computerized tracking and sensitive thromboplastin achieves high time in therapeutic range and low rates of major adverse events.

Cite This Study

Barbui et al. (1995) studied this question.

synapsesocial.com/papers/6a916dafca59a4cbdea1651d https://doi.org/10.1055/s-0038-1642730

Topics

Anticoagulation in AF

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Clinical Coagulation Laboratory and Oral Anticoagulant Therapy Treatment. Instrumentation and Methodology

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Clinical Coagulation Laboratory and Oral Anticoagulant Therapy Treatment. Instrumentation and Methodology

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider