Abohelaika, S. et al. (2018) Individual and monitoring centre influences upon anticoagulation control of AF patients on warfarin: a longitudinal multi-centre UK-based study. European Journal of Haematology, 101(4), pp. 486-495. (doi: 10.1111/ejh.13130) (PMID:29949204)
Full text not currently available from Enlighten.
Abstract
Objectives: Time within therapeutic INR range (TTR) predicts benefits/risk of warfarin therapy. Identification of individual- and centre-related factors that influence TTR, and addressing them to improve anticoagulation control, are important. This study examined the impact of individual and centre-related factors upon long-term anticoagulation control in atrial fibrillation patients in seven UK-based monitoring services. Methods: Data between 2000 and 2014 on 25 270 patients (equating to 203 220 patient years) [18 120 (71.7%) in general practice, 2348 (9.3%) in hospital-based clinics and 4802 (19.0%) in domiciliary service] were analysed. Results: TTR increased with increasing age, peaking around 77% at 70-75 years, and then declined, was lower in females than males, and in dependent home-monitored patients than those attending clinic (P < 0.0001). TTR, number of dose changes and INR monitoring events and the probability of TTR ≤ 65%, differed across the centres (P < 0.0001). Conclusions: Although all the participating centres ostensively followed a standard dosing algorithm, our results indicate that variations in practice do occur between different monitoring sites. We suggest feedback on TTR for individual monitoring sites gauged against the average values reported by others would empower the individual centres to improve quality outcomes of anticoagulation therapy by identifying and adjusting contributory factors within their management system.
| Item Type: | Articles |
|---|---|
| Status: | Published |
| Refereed: | Yes |
| Glasgow Author(s) Enlighten ID: | Tait, Dr Robert |
| Authors: | Abohelaika, S., Wynne, H., Avery, P., Robinson, B., Jones, L., Tait, C., Dickinson, B., Salisbury, J., Nightingale, J., Green, L., and Kamali, F. |
| College/School: | College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health |
| Journal Name: | European Journal of Haematology |
| Publisher: | Wiley |
| ISSN: | 0902-4441 |
| ISSN (Online): | 1600-0609 |
| Published Online: | 27 June 2018 |
University Staff: Request a correction | Enlighten Editors: Update this record
Deposit and Record Details
Deposit and Record Details