Literature DB >> 29025819

Time in therapeutic range: Warfarin anticoagulation for atrial fibrillation in a community-based practice.

Derek Gateman1, Melissa Elizabeth Trojnar2, Gina Agarwal3.   

Abstract

OBJECTIVE: To evaluate the effectiveness of an outpatient, nurse-administered warfarin anticoagulation protocol for the treatment of atrial fibrillation, and to identify clinical or biographical data that predict poor international normalized ratio control.
DESIGN: Retrospective cohort study.
SETTING: St Paul Family Health Network in Brantford, Ont. PARTICIPANTS: A total of 150 patients with nonvalvular atrial fibrillation. MAIN OUTCOME MEASURES: Time in therapeutic range (TTR) for each patient and for the clinic overall. The groups of patients above and below a target TTR of 60% were compared by stepwise binomial logistic regression.
RESULTS: A time-weighted average TTR for the clinic was determined to be 58.76%, based on 183 452 patient-days taking warfarin. The regression analysis did not find a statistically significant association between TTR and any predictors. A trend indicating a 5-fold increase in the odds of inadequate anticoagulation was observed in current smokers (odds ratio of 4.71; 95% CI 0.97 to 22.93).
CONCLUSION: Compared with data from prospective randomized trials and meta-analysis, the anticoagulation protocol employed at the St Paul Family Health Network produced an average TTR near the lower end of the target threshold. Current smokers might be at greater risk of being below this target. Copyright© the College of Family Physicians of Canada.

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Year:  2017        PMID： 29025819      PMCID： PMC5638490     

Source DB:  PubMed          Journal:  Can Fam Physician        ISSN： 0008-350X            Impact factor:   3.275


  20 in total

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3.  Anticoagulation management by community pharmacists in New Zealand: an evaluation of a collaborative model in primary care.

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4.  Anticoagulation control in Sweden: reports of time in therapeutic range, major bleeding, and thrombo-embolic complications from the national quality registry AuriculA.

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5.  Validation of clinical classification schemes for predicting stroke: results from the National Registry of Atrial Fibrillation.

Authors:  B F Gage; A D Waterman; W Shannon; M Boechler; M W Rich; M J Radford
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6.  Monitoring of international normalized ratios: comparison of community nurses with family physicians.

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8.  Benefit of oral anticoagulant over antiplatelet therapy in atrial fibrillation depends on the quality of international normalized ratio control achieved by centers and countries as measured by time in therapeutic range.

Authors:  Stuart J Connolly; Janice Pogue; John Eikelboom; Gregory Flaker; Patrick Commerford; Maria Grazia Franzosi; Jeffrey S Healey; Salim Yusuf
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9.  Pathways to poor anticoagulation control.

Authors:  Z Razouki; A Ozonoff; S Zhao; A J Rose
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10.  A method to determine the optimal intensity of oral anticoagulant therapy.

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2.  Standardized warfarin monitoring decreases adverse drug reactions.

Authors:  Lisa B E Shields; Paula Fowler; Diane M Siemens; Douglas J Lorenz; Kenneth C Wilson; Steven T Hester; Joshua T Honaker
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3.  Assessment of the quality of anticoagulation management with warfarin in a tertiary care center.

Authors:  Monirah A Albabtain; Maha M Alharthi; Khalid Dagriri; Amr A Arafat; Esraa Ayrout; Yahya Alhebaishi; Ahmed AlFagih
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4.  Pharmacogenetics of Anticoagulation and Clinical Events in Warfarin-Treated Patients: A Register-Based Cohort Study with Biobank Data and National Health Registries in Finland.

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5.  Association between transportation barriers and anticoagulation control among an inner-city, low-income population: A prospective observational cohort study.

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Review 6.  Anticoagulation control, outcomes, and associated factors in long-term-care patients receiving warfarin in Africa: a systematic review.

Authors:  Tamrat Assefa Tadesse; Gobezie Temesgen Tegegne; Dejuma Yadeta; Legese Chelkaba; Teferi Gedif Fenta
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  6 in total

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