A cross-sectional study of the Anticoagulation Clinic in RIPAS Hospital, Brunei

The number of patients seen at the RIPAS Hospital Anticoagulation Clinic (ACC) has increased cumulatively over the years. With patient numbers increasing dramatically, a study of the anticoagulant service has become necessary to determine the clinic's performance.

The aim of this study was to gather descriptive data on the ACC and to determine the percentage of patients' international normalised ratio (INR) results within target, below target and above target at the ACC.

A cross-sectional study was conducted for all patients attending the ACC in 2005 and 2006. Patient data were collected from their warfarin chart. The results were compared between the 2 years.

The numbers of patients were 364 and 390 in 2005 and 2006, respectively. The male-to-female ratio was 0.95 in 2005 and 1.14 in 2006. There was no significant change in ethnic distribution between the 2 years. Most of the patients seen at the ACC were Malays, followed by Chinese and other ethnicities consisting of Caucasian, Burmese, Bisaya, Gurkha, Iban and Filipino. There was a shift in the age of population in 2006 (mean = 60.2 +/- 14.0) compared to 2005 (mean = 58.1 +/- 14.1). Of the patients, 34.6% had multiple indications requiring anticoagulation in 2005 and 29.5% in 2006. The most common indications for patients were atrial fibrillation (63% in 2005 and 61% in 2006), prosthetic valve replacement (22% in 2005 and 18% in 2006) and thrombosis (4% in 2005 and 2006). These three indications accounted for 90% of patients seen. In 2005, 33.4% of INR were below target, 49.3% within target and 17.3% above target. In 2006, 36% were below target, 51.1% were within target and 12.9% were above target.

This was the first time such a study was conducted for the ACC. It helped us gauge our current performance, understand our practice and enable us to implement any necessary changes to improve the clinic.