Related Experiment Video

Updated: May 24, 2026

Rapid Point-of-Care Assay of Enoxaparin Anticoagulant Efficacy in Whole Blood
11:17

Rapid Point-of-Care Assay of Enoxaparin Anticoagulant Efficacy in Whole Blood

Published on: October 12, 2012

Interpretation and management of INR results: a case history based survey in 13 countries

Ann-Helen Kristoffersen1, Geir Thue, Eva Ajzner

  • 1Laboratory of Clinical Biochemistry, Haukeland University Hospital, Helse Bergen HF, Bergen, Norway. ann.kristoffersen@helse-bergen.no

Thrombosis Research
|March 20, 2012
PubMed

Insights

Vitamin K antagonist (VKA) treatment monitoring shows significant variation among physicians globally. This lack of standardization in VKA management may lead to clinical consequences, necessitating improved guidelines.

Area of Science:

  • Cardiology
  • Pharmacology
  • Internal Medicine

Background:

  • Standardization of treatment with vitamin K antagonists (VKAs) remains a challenge despite their long-standing use.
  • Existing VKA monitoring practices in primary and secondary care require exploration to identify areas for improvement.

Purpose of the Study:

  • To investigate physician practices regarding VKA monitoring in both primary and secondary care settings.
  • To identify variations in VKA management and their potential clinical implications.

Main Methods:

  • Distribution of two case histories (stable anticoagulation and supratherapeutic INR) to physicians across 13 countries.
  • Inquiry into INR measurement frequency, VKA dose adjustment thresholds, and perceived risks of stroke and bleeding.
  • Analysis of responses from 3016 physicians, predominantly from primary care.

Main Results:

  • Substantial variation in VKA monitoring practices observed within and between countries, irrespective of care level or VKA type.
  • Physicians frequently overestimated ischemic stroke and bleeding risks by 2-3 times.
  • Significant discrepancies in VKA dose reduction and timing of repeat INR measurements were noted, particularly in cases of supratherapeutic INR.

Conclusions:

  • Widespread variation in VKA monitoring indicates significant clinical consequences.
  • Current guidelines for VKA management may be inadequately known or perceived as impractical.
  • Enhanced efforts are crucial to standardize VKA management and improve patient outcomes.
Abstract

Related Concept Videos

Interpreting Run Charts01:25

Interpreting Run Charts

Run charts, essentially line graphs plotted over time, serve as fundamental yet effective tools for process analysis. They chronicle data sequentially, facilitating the identification of trends, shifts, or cyclical movements. This graphical representation is instrumental in determining whether a process is stable or exhibits signs of potential instability indicative of special cause variation. In the healthcare domain, run charts depict infection rates over time, enabling hospitals to monitor...
Interpreting R Charts01:22

Interpreting R Charts

R chart, or range chart, is a fundamental tool in statistical process control used to monitor the variability within a process. It complements the X-bar (x̄) chart by focusing on the range of the data, rather than individual values, providing a clear picture of the process dispersion over time.
An R chart plots the range of subsets of measurements collected from a process. Each point on the chart represents the range—defined as the difference between the maximum and minimum values—of a sample...
Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches01:23

Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches

Biopharmaceutical studies constitute a vital field aiming to enhance drug delivery methods and refine therapeutic approaches, drawing upon diverse interdisciplinary knowledge. In research methodologies, the choice between controlled and non-controlled studies significantly influences the study's reliability and accuracy.
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast, controlled...
Errors occurring during blood pressure monitoring01:25

Errors occurring during blood pressure monitoring

Blood pressure monitoring is a crucial clinical procedure in diagnosing and managing various cardiovascular conditions. Despite its significance, the accuracy of blood pressure measurements can be compromised by multiple factors, potentially leading to either falsely high or low readings. These inaccuracies are critical as they can significantly impact patient care. So, it is vital to understand these challenges deeply and adopt strategic approaches to minimize errors.
Several factors...
Therapeutic Index01:13

Therapeutic Index

The therapeutic index of a drug is a key parameter in pharmacology that quantifies the relative safety of a drug by calculating the ratio between the dose that causes toxicity in half the population (50%) to the dose that proves to be effective for half the population (50%). It provides a spectrum of doses for a particular drug ranging from effective to potentially toxic. To illustrate, consider an anticoagulant agent like warfarin. It possesses a narrow window within its therapeutic index to...
Assessment of blood pressure in brachial artery(one-step method)01:15

Assessment of blood pressure in brachial artery(one-step method)

This procedural guide systematically measures blood pressure using an oscillometric digital sphygmomanometer, emphasizing accuracy, patient safety, and comfort.
Prepare for the Procedure: