Anticoagulation Management With Coumarinic Drugs in Chilean Patients
Elena Nieto1, Marcelo Suarez2, Ángela Roco2,3,4
11 San Juan de Dios Hospital, Santiago, Chile.
Insights
In Chile, telemedicine improved oral anticoagulant use and quality indicators for patients with thromboembolic disease. This strategy enhanced time in therapeutic range for anticoagulation management.
Area of Science:
- Cardiology
- Pharmacology
- Public Health
Background:
- Oral anticoagulants like warfarin and acenocoumarol are crucial for managing thromboembolic disease in cardiovascular disorders.
- Limited data exist on the efficacy and safety of antithrombotic prophylaxis in Latin America, including Chile.
- The increasing number of patients requiring anticoagulant treatment in Chile necessitates local efficacy data.
Purpose of the Study:
- To evaluate the efficacy of oral anticoagulant therapy in Chilean patients.
- To identify factors influencing the quality of anticoagulant treatment in Chile.
- To assess the impact of telemedicine on anticoagulant management.
Main Methods:
- Retrospective analysis of 6280 patient records from the Western Metropolitan Health Service, Santiago, Chile.
- Data collection focused on diagnoses, prescribed anticoagulants (acenocoumarol vs. warfarin), and therapeutic doses.
- Evaluation of time in therapeutic range (TTR) and comparison between standard care and telemedicine interventions.
Main Results:
- The most common diagnoses were rhythm disorder (43.7%), venous thrombosis (22%), and valvular prosthesis (10.7%).
- Acenocoumarol was used by 98.5% of patients, with a median time in therapeutic range of 50% across all diagnoses.
- A telemedicine strategy in Santiago Province improved the median time in therapeutic range to 66.7%.
Conclusions:
- Telemedicine significantly enhances the quality of oral anticoagulant care in Chile.
- Implementing telemedicine strategies can improve therapeutic outcomes for patients on anticoagulation.
- Further research and implementation of telemedicine are recommended for optimizing anticoagulant therapy in Chile.
Abstract:
Warfarin and acenocoumarol are used in various cardiovascular disorders to improve the prognosis of patients with thromboembolic disease. However, there is a lack of substantial efficacy and safety data on antithrombotic prophylaxis in several countries, particularly in Latin America. The aim of this study was to provide information about the efficacy of anticoagulants in Chilean patients. Data were collected from databases of the Western Metropolitan Health Service, Santiago, Chile. We identified 6280 records of patients receiving anticoagulant treatment. The three most common diagnoses were rhythm disorder (43.7%), venous thrombosis (22%), and valvular prosthesis (10.7%). The majority of patients (98.5%) received acenocoumarol while 1.5% of patients received warfarin, at weekly therapeutic doses of 13.6 mg and 30.4 mg, respectively. For total diagnoses, the median time in the therapeutic range was 50%. However, better results, 66.7%, were observed when a telemedicine strategy was used only in Santiago Province. Our findings emphasize that in Chile, where the number of patients receiving anticoagulant treatment increases every year, telemedicine, by committed teams, improves the use of oral anticoagulants and is able to increase quality indicators of anticoagulant treatment care.
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