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A descriptive evaluation of warfarin use in patients receiving hospice or palliative care services
Robin R Hill1, Kerri D Martinez, Thomas Delate
1Department of Pharmacy, Kaiser Permanente, Aurora, CO 80014, USA. Robin.R.Hill@kp.org
Purpose:
To describe and compare warfarin therapy use and outcomes between warfarin-receiving patients in hospice or palliative care (HPC) and not in HPC.
Methods:
This retrospective, matched analysis examined warfarin-receiving patients who did (study cohort) and did not receive (control cohort) HPC services between 2002 and 2005. The matched cohorts were compared on rates of international normalized ratio (INR) measurements, INR control, and warfarin-related adverse events.
Results:
Included were 101 and 484 study and matched control patients, respectively. Study patients had a higher mean rate of INR measurements per 30 days (2.2 +/- 1.7 vs. 1.7 +/- 1.4, P = 0.001) and were more likely to be above and below target INR range (P < 0.05) than control patients. Differences between the cohorts in incidences of warfarin-related adverse events were not statistically significant (P > 0.05).
Conclusions:
Patients in HPC required more frequent INR monitoring but had similar risks for warfarin-related adverse events.
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