Key Points
- To determine whether anticoagulation clinics routinely incorporate ACCP consensus recommendations for oral phytonadione into clinical practice for warfarin-associated coagulopathy.
- Mailed surveys to 100 Anticoagulation Forum clinics in the southwestern United States.
- Presented 4 scenarios of asymptomatic patients taking warfarin with supratherapeutic international normalized ratio (INR) values and variable bleeding risk levels.
- Of 53 responding clinics, 25% (n=13) reported never using oral phytonadione, while 34% (n=18) reported using subcutaneous phytonadione contrary to 1998 ACCP recommendations.
- Only 32% of respondents (n=17) provided treatment management choices consistent with ACCP consensus recommendations across all 4 clinical scenarios.
Structured PICO
PPopulation53 responding anticoagulation clinics in the southwestern region of the United States (out of 100 surveyed)
IInterventionSurvey regarding the management of asymptomatic patients taking warfarin with supratherapeutic international normalized ratio (INR)
OOutcomeConsistency of clinic management with recommendations from the American College of Chest Physicians (ACCP) Fifth Consensus Conference on Antithrombotic Therapy
A substantial number of anticoagulation clinics underutilize oral vitamin K (phytonadione) for patients with supratherapeutic INR, indicating a gap between clinical practice and ACCP guidelines.