Standardized warfarin monitoring decreases adverse drug reactions

Autor: Lisa B E Shields, Kenneth C. Wilson, Joshua T. Honaker, Diane M. Siemens, Douglas J. Lorenz, Paula Fowler, Steven T. Hester
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Zdroj: BMC Family Practice, Vol 20, Iss 1, Pp 1-7 (2019)
BMC Family Practice
ISSN: 1471-2296
DOI: 10.1186/s12875-019-1041-5
Popis: Background While warfarin is the most commonly prescribed medication to prevent thromboembolic disorders, the risk of adverse drug reactions (ADR) poses a serious concern. This prospective study evaluated how primary care providers (PCP) and cardiologists at our Institution managed patients treated with warfarin with the goal of decreasing the number of warfarin ADRs. Methods A multidisciplinary anticoagulation task force was established at our Institution in 2014 to standardize warfarin monitoring and management. Between 2013 and 2017, we analyzed patients who were prescribed warfarin by their PCP or cardiologist upon hospital discharge and in the ambulatory setting to determine the international normalized ratio (INR) within 5, 10, and 30 days after discharge, time in therapeutic range (TTR), number of severe warfarin ADRs, and total and average cost reduction of all severe warfarin ADRs to determine whether there was an organizational cost savings following the implementation of standardized warfarin care. Results The warfarin ADR rate significantly decreased over the 5-year period, from 3.8 to 0.98% (p p p Conclusions This study serves as a model to reduce the number of severe warfarin ADRs by the following tactics: (1) educating PCPs and cardiologists about evidence-based guidelines for warfarin management, (2) increasing the use of our Institution’s electronic warfarin module, and (3) enhancing patient compliance with obtaining INR.
Databáze: OpenAIRE
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