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Quality of anticoagulation management with warfarin among outpatients in a tertiary hospital in Addis Ababa, Ethiopia: a retrospective cross-sectional study
- Source :
- BMC Health Services Research, Vol 17, Iss 1, Pp 1-7 (2017), BMC Health Services Research
- Publication Year :
- 2017
- Publisher :
- BMC, 2017.
-
Abstract
- Background Warfarin is the most widely used anticoagulant in the world. The difficulty of managing warfarin contributes to great potential for patient harm, both from excessive anticoagulation and insufficient anticoagulation. This study assessed the International Normalized Ratio (INR) control outcome measures and warfarin dose adjustment practices at cardiology and hematology outpatient clinics at a teaching hospital in Addis Ababa, Ethiopia. Methods The study was based on a cross - sectional study design involving 360 retrospective patients’ chart review among outpatients who received warfarin for its various indications. Results The mean frequency of INR monitoring per patient was 62.9 days (17.2–143.7 days). Patients spent 52.2%, 29.0% and 18.8% of the time in sub-therapeutic, therapeutic and supra-therapeutic ranges, respectively. The daily warfarin dose was increased 50.9% and 36.9% and decreased in 52.8% and 60.9% of the time for occurrences of sub-therapeutic and supra-therapeutic INRs to achieve target ranges of 2.0–3.0 and 2.5–3.5, respectively. Conclusion The quality of anticoagulation management with warfarin among outpatients in Tikur Anbessa Specialized Hospital was sub-optimal. This was reflected by low Time in Therapeutic Range (TTR), longer than recommended INR monitoring frequency, and minimal actions taken to adjust warfarin dose after occurrences of non-therapeutic INRs.
- Subjects :
- Male
Inr
Pediatrics
medicine.medical_specialty
Cross-sectional study
medicine.drug_class
Anticoagulation management
030204 cardiovascular system & hematology
Ambulatory Care Facilities
Health administration
Tertiary Care Centers
03 medical and health sciences
0302 clinical medicine
Tikur Anbessa specialized hospital
INR self-monitoring
Outpatients
Humans
Medicine
Outpatient clinic
Thrombolytic Therapy
heterocyclic compounds
International Normalized Ratio
030212 general & internal medicine
cardiovascular diseases
Time in therapeutic range
Hospitals, Teaching
Aged
Retrospective Studies
business.industry
Health Policy
lcsh:Public aspects of medicine
Anticoagulant
Warfarin
Anticoagulants
Retrospective cohort study
lcsh:RA1-1270
Middle Aged
Cross-Sectional Studies
Female
Ethiopia
business
Research Article
medicine.drug
Subjects
Details
- Language :
- English
- ISSN :
- 14726963
- Volume :
- 17
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- BMC Health Services Research
- Accession number :
- edsair.doi.dedup.....60db51d4cbf5e004a9d05d3b20d76cf4