Quality of Warfarin Therapy and Quality of Life are Improved by Self-Management for Two Years.
| Autor: | Sølvik UØ; Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway., Løkkebø E; Norwegian Organization of Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital, Bergen, Norway., Kristoffersen AH; Norwegian Organization of Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital, Bergen, Norway.; Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway., Brodin E; Division of Medicine, Department of Hematology, Akershus University Hospital, Lørenskog, Norway., Averina M; Department of Laboratory Medicine, The University Hospital of North Norway, Tromsø, Norway., Sandberg S; Department of Global Public Health and Primary Care, Faculty of Medicine, University of Bergen, Bergen, Norway.; Norwegian Organization of Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital, Bergen, Norway.; Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway. |
|---|---|
| Jazyk: | angličtina |
| Zdroj: | Thrombosis and haemostasis [Thromb Haemost] 2019 Oct; Vol. 119 (10), pp. 1632-1641. Date of Electronic Publication: 2019 Aug 01. |
| DOI: | 10.1055/s-0039-1693703 |
| Abstrakt: | Background: Studies from several countries show that self-management of vitamin K antagonist (e.g., warfarin) therapy reduce the risk of complications compared with conventional management. Objectives: The aim of this study was to investigate the quality of warfarin management when patients were transferred from conventional management to self-management in Norway. In addition, quality of life (QoL) before and after 2 years of warfarin self-management was investigated. Materials and Methods: The study was longitudinal with a retrospective and prospective design where 126 patients on conventional management of long-term warfarin therapy underwent a 21-week training program of warfarin self-management followed by 2 years of self-management. The outcomes of the study were time in therapeutic range (TTR), the variance of international normalized ratio (INR) values, extreme INR values (INR ≤ 1.5 and ≥ 5), complications, and QoL, comparing the 2-year period of the conventional management with the 2-year period with the self-management. Results: The median TTR was higher during self-management compared with conventional management (78.1% vs. 65.9%, respectively, p < 0.001). In addition, self-management resulted in lower INR variance (0.22 vs. 0.33, p < 0.001), reduced percentage of extreme INR values (1.8% vs. 5.3%, p < 0.001), less complications (0% vs. 5.6%), and improved QoL ( p < 0.001) compared with conventional management. Conclusion: We used five different measures and found improved quality of warfarin self-management 2 years after patients were transferred from the conventional management. Competing Interests: A.H.K. reports grants from The Western Regional Health Authorities, during the conduct of the study. All the other authors report no conflict of interest. (Georg Thieme Verlag KG Stuttgart · New York.) |
| Databáze: | MEDLINE |
| Externí odkaz: |
|