Improving Anticoagulation Therapy Using Point-of-Care Testing and a Standardized Protocol
| Autor: | Lori M. Dickerson, Peter J. Carek, Curtis A. Franke |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
Adult
Male endocrine system medicine.medical_specialty Quality Assurance Health Care Office Visits Point-of-Care Systems Office visits Point-of-care testing Primary care Clinical Protocols Ambulatory care INR self-monitoring health services administration Ambulatory Care medicine Humans Thrombolytic Therapy heterocyclic compounds International Normalized Ratio cardiovascular diseases Dosing Aged Original Research Protocol (science) Dose-Response Relationship Drug business.industry Warfarin Anticoagulants Middle Aged United States Practice Guidelines as Topic Physical therapy Female Family Practice business Algorithms medicine.drug |
| Zdroj: | The Annals of Family Medicine. 6:S28-S32 |
| ISSN: | 1544-1717 1544-1709 |
| DOI: | 10.1370/afm.739 |
| Popis: | PURPOSE Many patients in primary care require anticoagulation with warfarin for the prevention of venous and systemic embolism. Achieving the goal international normalized ratio (INR) with warfarin is challenging. The purpose of this quality improvement initiative was to increase the proportion of patients taking warfarin with an INR value within the goal range. METHODS We included all patients identified on an anticoagulation log in the family medicine residency practice during 3 time periods: baseline, after point-of-care (POC) testing was initiated (intervention period 1), and after a standardized warfarin-dosing protocol was implemented (intervention period 2). Educational sessions were conducted during each intervention period. Measures included the frequency of INR monitoring and the percentage of office visits in which patients’ values were within the goal INR range. Data were analyzed using descriptive statistics, the Student t test, and the χ2 test. RESULTS At baseline, patients had an average of 2.6 INR tests performed, and 30.8% were within the INR goal range. Using POC testing, the frequency of monitoring increased to 4.3 INR tests per patient (P = .04), but the percentage of patients within the INR goal remained low at 32.1% (P=.88). When physicians implemented the standardized protocol to guide warfarin dosing, the frequency of testing was similar (3.8 tests per patient), but the percentage of patients within the INR goal increased to 45.9% (P |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|