Key result
Computer-aided warfarin dosing using CoagClinic significantly increased the time in therapeutic range to 71% compared to 26% with physician dosing (p=0.015).
Why the study?
Does computer-aided warfarin dosing improve the time in therapeutic range (TTR) compared to physician dosing in patients with cardiac indications?
Observational (n=70)
No
Does computer-aided warfarin dosing improve the time in therapeutic range (TTR) compared to physician dosing in patients with cardiac indications?
Absolute Event Rate: 71% vs 26%
p-value: p=0.015
Computer-aided warfarin dosing significantly improves the time in therapeutic range (TTR) compared to routine physician dosing in patients with cardiac indications.
Coagclinic may improve TTR versus physician dosing; leaves open confirmation in randomized trials before any practice shift.
Purpose: To compare the efficacy of computer-aided dosing using Coagclinic (a web-based software) with physician dosing in patients receiving warfarin for various cardiac indications.Methods: In order to calculate the effectiveness of physician managed anticoagulation dosing, we calculated the “percentage of time international normalized ratio, INR, was in the therapeutic range" (TTR) for a random sample of 70 patients in the center. For each patient, 4 INR values were taken at 4 consecutive visits, before and after the installation of Coagclinic. Data on the doses given by physicians were collected at each visit and c omp ar ed them with the pharmacy-based computer aided dosing system data.Results: After performing paired samples t-test of doses based on the physician group with those based on the computer system (mean -1.5654 ± 2.09 ), a statistically significant difference was found (p < 0.015). Furthermore, the patients kept at TTR by physicians amounted to 26 % compared to 70 % by the software.Conclusion: The difference between TTR managed by physicians and those managed using CoagClinic™ software is statistically significant. It appears that the software improves the effectiveness of warfarin dosing in patients.
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Almeman et al. (2014) conducted an observational in Cardiac indications requiring warfarin therapy (n=70). Computer-aided warfarin dosing (CoagClinic) vs. Physician dosing was evaluated on Time in therapeutic range (TTR) (p=0.015). Computer-aided warfarin dosing using CoagClinic significantly increased the time in therapeutic range to 71% compared to 26% with physician dosing (p=0.015).
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