Related Experiment Videos
Improved control of oral anticoagulant dosing: a randomized controlled trial comparing two computer algorithms.
Y van Leeuwen1, E K Rombouts, C J Kruithof
1Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, The Netherlands.
Journal of Thrombosis and Haemostasis : JTH
|May 10, 2007
Summary
A new computer algorithm for oral anticoagulant dosing significantly increased dosage proposals and physician acceptance, improving monitoring efficiency without compromising therapeutic quality.
Area of Science:
- Pharmacology and Therapeutics
- Medical Informatics
- Control Engineering
Background:
- Computer algorithms aim to enhance oral anticoagulant dosing quality.
- Existing algorithms are limited, proposing dosages for a small patient fraction.
- A novel algorithm, based on system and control engineering, was developed to provide proposals for nearly all patients.
Purpose of the Study:
- To clinically evaluate a new computer-assisted oral anticoagulant dosing algorithm.
- Compare the efficacy and efficiency of the new algorithm (ICAD) against a standard algorithm (TRODIS).
Main Methods:
- A double-blind randomized controlled trial involving 712 patients undergoing long-term anticoagulant therapy.
- Comparison of oral anticoagulant dosing management using the new ICAD algorithm versus the standard TRODIS algorithm.
Main Results:
- Therapeutic range time was similar between groups (79.8% vs. 80.2%).
- The ICAD algorithm generated proposals in 97.5% of visits, compared to 60.8% for TRODIS.
- ICAD proposals were accepted by physicians in 77.4% of patient visits, versus 55.3% for TRODIS.
Conclusions:
- The new algorithm substantially increased the generation and acceptance of dosage proposals.
- This advancement enhances the efficiency of anticoagulant monitoring.
- The improved efficiency is achieved without a reduction in the quality of therapeutic control.
Related Concept Videos
01:18Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
01:29Venous Thrombosis III: Interprofessional Care
Venous thrombosis requires effective prevention and treatment strategies to improve patient outcomes and reduce potential complications.Prevention StrategiesHealthcare providers must prioritize preventing venous thromboembolism (VTE) for all adult patients upon admission. Interventions depend on bleeding and thrombosis risk, medical history, current medications, diagnoses, planned procedures, and patient preferences. Patients on bed rest should change positions every two hours and, if not...
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
01:28IV Infusion to Oral Dosing: Conversion Methods
The development of extended-release formulations has facilitated the transition from intravenous to oral medication, offering a more convenient and patient-friendly approach to drug administration. This transition, however, requires careful management to ensure that therapeutic drug levels are maintained, preserving efficacy and avoiding adverse effects. Understanding pharmacokinetic principles and dosage calculations is critical during this process.Pharmacokinetics of the...
01:25Dosage Regimen: Multiple Oral Dosage
Understanding how a drug's concentration fluctuates within the body over time is crucial in pharmacokinetics, particularly with multiple oral doses. A graphical representation of multiple oral dosages provides insight into these dynamics. Typical accumulation curves of a drug's concentration in the body reveal a sawtooth pattern, indicating periodic peaks and troughs correlating with each dose administration and the drug's subsequent elimination.The plasma concentration at any time during an...
01:28Dosage Regimens: Designs and Approaches
Designing a dosage regimen, which refers to the manner of drug administration, is a complex process involving the selection of drug dose, route, and frequency. This process is underpinned by pharmacokinetic parameters derived from tests and population averages. These parameters are then tailored to patient-specific variables such as diagnosis, demographics, and allergy status. Once therapy commences, therapeutic response monitoring is critical and achieved through clinical and physical...