Murray, Nigel P.; Jara, Sylvia Odette; Cárdenas, Mercedes; Sottovia, Mónica; Cea V., Pamela
December 2008
Revista Chilena de Tecnología Médica;2008, Vol. 28 Issue 2, p1447
Academic Journal
Objective: An audit of the clinical gestion of a ambulatory anticoagulation clinic, before and after implementing a clinical guide, an education programme for patients and management criteria based on international guidelines. Methods: All patients with oral anticoagulation attending the Outpatients clinic in the Hospital de Carabineros de Chile were included in the prospective study. Measured criteria included, % of patients with an INR > 8, in the range 5-8 and < 1,5. The period of time with an INR +/- 0,5 and +/- 1,0 of the target INR was calculated. In November 2007 and March 2008 a complete analysis of all patients was carried out, while in December 2007, January and February 2008 a summary was analysed. Results: The overall control of anticoagulation significantly improved in the 4 month period (p<0.02), with less patients having an INR >5 (p<0.0000002), the percentage of patients with an INR <1.5 remained unchanged. The time spent within +/- 1.0 units INR significantly improved (p<0.05), although in the range +/- 0,5 there was no change. Conclusions: We have demonstrated that with patient education and stricter controls the management of outpatient anticoagulation can be improved in the short term, decreasing the number of patients with an INR > 5,0 with the risk of haemorrhage.


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