Poor anticoagulation control in patients taking warfarin at a tertiary and district-level prothrombin clinic in Cape Town, South Africa

South African Medical Journal = Suid-Afrikaanse Tydskrif Vir Geneeskunde
I EbrahimM Blockman

Abstract

Warfarin is the most commonly used anticoagulant for both primary and secondary prevention of thromboembolism. For anticoagulation efficacy, the international normalised ratio (INR) needs to be within the therapeutic range for at least 65% of time on warfarin. To describe INR control in patients on long-term warfarin and identified predictors of good INR control at two dedicated warfarin follow-up clinics in Cape Town, South Africa (SA). We reviewed clinical records of patients in care at the INR clinics at Mitchell's Plain Community Health Centre and Groote Schuur Hospital. We included patients who had been on warfarin therapy for at least 27 months and excluded patients with <6 months of INR monitoring data or a >70-day gap between INR tests in the calculation period, and if >25% of follow-up time was at an alternative site. The time in therapeutic range (TTR) over 180 days using the Rosendaal method was calculated, and we categorised INR control as good if the TTR was ≥65%. We constructed a multivariate logistic regression model to identify associations with good INR control. We included 363 patients, with a median age of 55 years (interquartile range (IQR) 44 - 64), of whom 65.6% were women. The most common indicat...Continue Reading

Citations

Mar 19, 2019·Omics : a Journal of Integrative Biology·Arinao NdadzaCollet Dandara
Oct 10, 2019·Journal of Cardiovascular Electrophysiology·Jean Jacques Noubiap, Ulrich Flore Nyaga
Dec 7, 2020·Clinical Pharmacology and Therapeutics·Innocent G AsiimweMunir Pirmohamed
Jan 1, 2021·European Heart Journal Supplements : Journal of the European Society of Cardiology·Itamar S SantosUNKNOWN NIHR Global Health Group on Atrial Fibrillation Management
Feb 16, 2021·British Journal of Clinical Pharmacology·Johannes P MoutonKaren Cohen
Feb 25, 2021·British Journal of Clinical Pharmacology·Jerome Roy SemakulaCatriona Waitt
May 12, 2021·British Journal of Clinical Pharmacology·Catiane Costa VianaMaria Auxiliadora Parreiras Martins
Nov 3, 2021·Clinical and Applied Thrombosis/hemostasis : Official Journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis·Nuredin Shiferaw YimerTamrat Assefa Tadesse

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