Profiles of patients on warfarin anticoagulation therapy in a leading tertiary referral hospital in Kenya; findings and implications for Kenya.

Autor:	Nyamu DG; Department of Pharmaceutics & Pharmacy Practice, School of Pharmacy, University of Nairobi, Nairobi, Kenya., Guantai AN; Department of Pharmacology & Pharmacognosy, School of Pharmacy, University of Nairobi, Nairobi, Kenya., Osanjo GO; Department of Pharmacology & Pharmacognosy, School of Pharmacy, University of Nairobi, Nairobi, Kenya., Godman B; Division of Clinical Pharmacology, Karolinska Institute, Karolinska University Hospital Huddinge, Stockholm, Sweden.; Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK.; Department of Pharmacy, Faculty of Health Sciences, Sefako Makgatho Health Sciences University, Pretoria, South Africa., Aklillu E; Division of Clinical Pharmacology, Karolinska Institute, Karolinska University Hospital Huddinge, Stockholm, Sweden.
Jazyk:	angličtina
Zdroj:	Expert review of cardiovascular therapy [Expert Rev Cardiovasc Ther] 2020 Mar; Vol. 18 (3), pp. 165-173. Date of Electronic Publication: 2020 Mar 02.
DOI:	10.1080/14779072.2020.1734452
Abstrakt:	Background : Patients' profiles affect the outcome with warfarin; however, this data, and its implications, is scarce in resource-poor countries without access to pharmacogenetics or regular INR testing. Objectives : To characterize the profiles of patients on long-term warfarin therapy and subsequently use these to guide future anticoagulation management. Methods : Cross-sectional study among 180 adult patients receiving warfarin therapy in at a leading referral hospital in Kenya. Sociodemographic characteristics were obtained through face-to-face interviews. Details of warfarin therapy, concomitant medication and comorbidities were retrieved from medical records. Associations between patients' profiles and the clinical indications of anticoagulation were computed at p ≤ 0.05. Results : Warfarin maintenance dose was 6.17 (±2.75) mg per day. Venous thromboembolism (56.6%) amongst obese patients (p = 0.0019) and cardioembolic events (48.3%) among males (p = 0.0316) aged ≤50 years (p = 0.0436) whose body mass indices were ≤ 25 (p < 0.0001) were the most common indications. Two-fifths and 45.0% of the patients had at least one other disease and concomitant medications. Conclusions : Long term warfarin therapy among Kenyans is mainly for overweight or lean middle-aged individuals suffering from venous or cardioembolic diseases. Studies should correlate patients' profiles with warfarin response to guide future management.
Databáze:	MEDLINE
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