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[Anticoagulation clinics for outpatients: a 5-year experience]
Y Benhamou1, V Le Cam-Duchez, J-M Schneller
1Département de médecine interne, CHU Bois-Guillaume, 147, avenue du Maréchal-Juin, 7620 Bois-Guillaume, 76031 Rouen cedex, France. ygal.benhamou@chu-rouen.fr
La Revue De Medecine Interne
|March 21, 2009
Summary
Computer-assisted management in a general medicine center achieved 72% of patients within the target INR range for oral anticoagulation. This approach demonstrated outcomes comparable to hospital-based clinics, with fewer thrombotic events.
Area of Science:
- Cardiology
- Internal Medicine
- Pharmacology
Context:
- Anticoagulation clinics improve therapeutic range adherence and reduce mortality/morbidity.
- Hospital-based centers typically manage chronic oral anticoagulation.
- This study evaluates a general medicine center's computer-assisted anticoagulation management (CSCTA).
Purpose:
- To report five-year outcomes of computer-assisted chronic oral anticoagulation management in a primary care setting.
- To assess the effectiveness of CSCTA in maintaining the international normalized ratio (INR) within therapeutic ranges.
- To compare CSCTA outcomes with those of traditional anticoagulation clinics.
Summary:
- A 5-year prospective observational study included 530 primary care patients on long-term oral anticoagulation.
- CSCTA achieved 72% of patients within the 2-3 INR range and 82% within the 1.5-4.5 INR range.
- Hemorrhagic and thrombotic complication rates were 4.9 and 0.75 per 100 patient-years, respectively.
Impact:
- CSCTA outcomes for hemorrhagic complications and time in therapeutic range are comparable to hospital-based anticoagulation clinics.
- Thrombotic events were less frequent in the CSCTA group compared to reported data from other clinics.
- This study highlights the potential of primary care-based computer-assisted management for oral anticoagulation.
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