Outpatient oral anticoagulant management--an audit of 82 patients.
Article
in English
| IMSEAR
| ID: sea-87960
ABSTRACT
OBJECTIVE:
Use of oral anticoagulants for thrombotic diseases has been increasing steadily over the years. Management practices however, are far from uniform. We conducted a retrospective audit among outpatients on oral anticoagulant therapy to assess treatment practices and overall control of anticoagulation.METHODS:
Case records of 82 patients who were on anticoagulant therapy for a minimum duration of three months were reviewed. Information on pre-therapeutic assessment of patients, therapeutic control and complications seen during the course of treatment was recorded.RESULTS:
Case notes of 43 males and 39 females with a mean age of 47.5 +/- 14.6 years, on oral anticoagulant treatment were evaluated. Treatment duration ranged from 3 months to 7 years for a total of 258.7 patient treatment years. Pre-therapeutic assessment of patients was inadequate with only baseline hematological and renal parameters available for most patients. Of a total of 1631 prothrombin time ratios and International Normalized Ratios recorded, only 17.8% were in the therapeutic range with 73% being sub-therapeutic. Sixteen (19.5%) patients had treatment related complications. The number of thrombotic and hemorrhagic events per 100 patient treatment years was 3.4 and 2.7 respectively.CONCLUSIONS:
Pre-therapeutic assessment of patients was inadequate. The overall therapeutic control was poor with patients in a state of underanticoagulation for most period of anticoagulant treatment. The complication rate was also unacceptably high. There is a need to reassess management practices of patients on long term oral anticoagulation with strict adherence to standard accepted guidelines to make this therapy more effective and safer for patients.
Full text:
Available
Index:
IMSEAR (South-East Asia)
Main subject:
Aged
/
Female
/
Humans
/
Male
/
Thrombolytic Therapy
/
Administration, Oral
/
Retrospective Studies
/
Adolescent
/
Drug Monitoring
/
Adult
Type of study:
Practice guideline
/
Observational study
Country/Region as subject:
Asia
Language:
English
Year:
2005
Type:
Article
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