Economic Evaluation of Point-of-Care Monitoring Devices for Long-Term Oral Anticoagulation Therapy

2007 ◽  
Author(s):  
Allan G. Brown ◽  
Phil Wells ◽  
Jim Jaffey ◽  
Lynda McGahan ◽  
Man-Chiu Poon ◽  
...  
Keyword(s):  
Economic Evaluation ◽  
Oral Anticoagulation ◽  
Point Of Care ◽  
Anticoagulation Therapy ◽  
Oral Anticoagulation Therapy ◽  
Monitoring Devices

scholarly journals Outpatient Management of Oral Anticoagulation Therapy in Patients with Nonvalvular Atrial Fibrillation

2009 ◽  
Vol 9 (4) ◽  
pp. 313-319 ◽  
Author(s):  
Aida Kulo ◽  
Nedžad Mulabegović ◽  
Jasna Kusturica ◽  
Hasija Hadžić ◽  
Lejla Burnazović-Ristić ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Oral Anticoagulation ◽  
Anticoagulation Therapy ◽  
Dose Titration ◽  
Nonvalvular Atrial Fibrillation ◽  
Annual Dose ◽  
Oral Anticoagulation Therapy ◽  
Anticoagulation Treatment ◽  
One Year

Due to heightened risk for thromboembolic complications, nonvalvular atrial fibrillation (NVAF) presents an absolute indication for long-term oral anticoagulation therapy. This was an observational, analytical, randomised, one-year clinical study, conducted in the Blood Transfusion Institute Sarajevo, Bosnia & Herzegovina. The aim of this study was to present the oral anticoagulation treatment in terms of International normalised ratio (INR) monitoring and warfarin/acenocoumarol dose titration in 117 patients with NVAF. INR values, the doses of warfarin and acenocoumarol, as well as the tendency and adequacy of their changes were monitored. Percentages of the therapeutic INR values were 51,77% and 53,62%, subtherapeutic 42,84% and 35,86%, and supratherapeutic 5,39% and 10,53% for the warfarin and acenocoumarol treatment, respectively. The average total weekly doses (TWD) which most frequently achieved the therapeutic INR values were 27,89±12,34 mg and 20,44±9,94 mg, for warfarin and aceno- coumarol, respectively. The dose changes with the INR values 1,7 or lower/3,3 or higher were omitted in 13,46% and 15,63%, and with the INR values 1,8-3,2 were noted in 8,62% and 13,48% of all the check-up visits in the warfarin and acenocoumarol group, respectively. The annual dose changes were noted in 24,65% and 31,41%, and the daily dose changes in 74,43% and 73,36% of all the check-up visits of warfarin and acenocoumarol group, respectively. We can conclude that the management of the oral anticoagulation treatment in our country is in accordance with the relevant recommendations, but with the present tendency toward underdosing and unnecessary frequent dose changing.

Implementation of SintromacWeb®, a new internet-based tool for oral anticoagulation therapy telecontrol: Study on system consistency and patient satisfaction

2010 ◽  
Vol 103 (05) ◽  
pp. 1091-1101 ◽  
Author(s):  
Yolanda Mira ◽  
María Teresa Contreras ◽  
Cristina Aguado ◽  
José Antonio Aznar ◽  
Fernando Ferrando
Keyword(s):  
Patient Satisfaction ◽  
Oral Anticoagulation ◽  
Point Of Care ◽  
Anticoagulation Therapy ◽  
International Normalized Ratio ◽  
Final Visit ◽  
Normal Range ◽  
Oral Anticoagulation Therapy ◽  
Self Testing ◽  
Anticoagulated Patients

SummaryMost computer- or internet-assisted systems for oral anticoagulation therapy (OAT) telemanagement have limitations when it comes to implementation within a healthcare center. It was the objective of this study to evaluate convenience and patient satisfaction with the use of SintromacWeb→, a new OAT telecontrol system, compared with the conventional control. SintromacWeb® consists of a point-of-care device for patient international normalized ratio (INR) self-testing and software that allows internet mediated interaction with physicians. Patients initiated the use of SintromacWeb→ and were followed up during a three-month period. A score-based questionnaire was completed in three controlled visits, and data were subsequently analysed. A total of 102 patients were enrolled. At first visit, 55.7% of the patients had their INR within normal range, and 64.9% at the final visit. Internal consistency of the questionnaire was good (Cronbach‘s α: 0.79). Scores in the questionnaire were independent of patient’s age, education level, working status and INR value. The most valued features of SintromacWeb® were: fewer visits to the hospital, simplicity and convenience of the system, and time administration for control tasks (86.7%, 82.7% and 77.6% of very satisfied patients, respectively). Also, patients showed indifference or were dissatisfied with the conventional system. At the final visit, 99% of patients declared that they were satisfied with their OAT control. Moreover, all patients continued using Sintrom -acWeb→ after completion of the study. In conclusion, SintromacWeb→ telecontrol is a new model for management of anticoagulated patients. It was highly accepted and can be used by all patients regardless of their sociodemographic characteristics.

Coronary Stent Implantation in Patients Committed to Long-term Oral Anticoagulation Therapy

CHEST Journal ◽  
2011 ◽  
Vol 139 (5) ◽  
pp. 981-987 ◽  
Author(s):  
Andrea Rubboli ◽  
Jason C. Kovacic ◽  
Roxana Mehran ◽  
Gregory Y.H. Lip
Keyword(s):  
Oral Anticoagulation ◽  
Stent Implantation ◽  
Anticoagulation Therapy ◽  
Coronary Stent ◽  
Oral Anticoagulation Therapy ◽  
Coronary Stent Implantation

P4799Long-term thromboembolic risk in patients with postoperative atrial fibrillation after left-sided heart valve surgery

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
J H Butt ◽  
J B Olesen ◽  
A Gundlund ◽  
P S Olsen ◽  
E Havers-Borgersen ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Mitral Valve ◽  
Heart Valve ◽  
Oral Anticoagulation ◽  
Anticoagulation Therapy ◽  
Valve Surgery ◽  
Heart Valve Surgery ◽  
Oral Anticoagulation Therapy ◽  
New Onset

Abstract Background New-onset postoperative atrial fibrillation (POAF) is a common complication of cardiac surgery. However, data on the long-term risk of thromboembolism in patients who develop POAF after heart valve surgery are sparse. In addition, data on stroke prophylaxis in this setting are lacking. Objective To assess the long-term risk of thromboembolism in patients developing new-onset POAF following isolated left-sided heart valve surgery relative to patients with nonsurgical, nonvalvular atrial fibrillation (NVAF). Methods Using data from the Eastern Danish Heart Surgery Database and Danish nationwide registries, we identified patients who developed POAF following isolated left-sided heart valve surgery (i.e. biologic aortic/mitral valve replacement or aortic/mitral valve repair) from 2000 through 2015. These patients were matched with patients with nonsurgical NVAF in a 1:4 ratio by age, sex, heart failure, hypertension, diabetes, a history of thromboembolism, ischemic heart disease, and year of diagnosis. Long-term risk of thromboembolism was examined by the Aalen-Johansen estimator and cause-specific Cox regression models adjusted for comorbidities, concomitant pharmacotherapy, and oral anticoagulation therapy as a time-dependent covariate. Results A total of 1,539 patients undergoing isolated left-sided heart valve surgery were identified. Of these, 716 (46.5%) patients developed POAF after surgery. A total of 630 patients with POAF were matched with 2,520 patients with NVAF. In the matched study population, the median age was 71 years (25th-75th percentile 66–77 years) and 59.5% were men. Oral anticoagulation therapy was initiated within 30 days post-discharge in 62.7% and 51.4% of these patients, respectively. Compared with NVAF, POAF was not associated with a significantly different 5-year absolute risk of thromboembolism (10.7% [95% confidence interval [CI], 8.0%-13.9%] versus 8.9% [95% CI, 7.6%-10.2%] in the POAF and NVAF group, respectively) (Figure). In the adjusted analysis, the long-term risk of thromboembolism was similar in patients with POAF and NVAF (hazard ratio [HR] 1.01 [95% CI, 0.71–1.44]). Anticoagulation therapy during follow-up was associated with a lower risk of thromboembolic events in patients with POAF (HR 0.45 [95% CI, 0.18–0.99]) as well as NVAF (HR 0.58 [95% CI, 0.42–0.80]) compared with no anticoagulation therapy. Conclusions New-onset POAF following isolated left-sided heart valve surgery was associated with a similar long-term risk of thromboembolism compared with NVAF. Future studies addressing the role of oral anticoagulation therapy in POAF after heart valve surgery are warranted to examine the efficacy and safety as well as the timing and duration of anticoagulation therapy.

Accuracy of point of care coagulometers compared to reference laboratory measurements in patients on oral anticoagulation therapy

2016 ◽  
Vol 140 ◽  
pp. 66-72 ◽  
Author(s):  
Jean-Guillaume Dillinger ◽  
Thiziri Si Moussi ◽  
Natacha Berge ◽  
Claire Bal Dit Sollier ◽  
Patrick Henry ◽  
...  
Keyword(s):  
Oral Anticoagulation ◽  
Point Of Care ◽  
Anticoagulation Therapy ◽  
Reference Laboratory ◽  
Laboratory Measurements ◽  
Oral Anticoagulation Therapy
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