Long-term oral anticoagulant therapy in elderly patients
Related Experiment Videos
L S Wickramasinghe1, S K Basu, S K Bansal
1Department of Medicine for the Elderly, District General Hospital, Sunderland.
Insights
This study found that while patient factors like age and mobility didn't affect anticoagulant control, concomitant drug therapy significantly impacted warfarin management. Poor control was linked to specific drug interactions and frequent medication changes.
Area of Science:
- Geriatric Medicine
- Pharmacology
- Clinical Pharmacy
Background:
- Anticoagulant therapy is crucial for managing various cardiovascular conditions.
- Effective anticoagulant control is essential to prevent thromboembolic events and minimize bleeding risks.
- Factors influencing anticoagulant control in elderly patients require thorough investigation.
Purpose of the Study:
- To evaluate the efficacy of anticoagulant control in elderly patients.
- To identify factors associated with anticoagulant control, complications, and treatment failures.
- To assess the impact of concomitant drug therapy on warfarin management.
Main Methods:
- A cohort of 49 elderly patients (65-89 years) on anticoagulant therapy was studied over 195 patient-years.
- Data collected included patient demographics, medication regimens, and clinical outcomes.
- Statistical analysis was performed to correlate various factors with anticoagulant control and adverse events.
Main Results:
- Anticoagulant control and outcomes were not significantly influenced by age, sex, social status, mobility, visual acuity, or supervision.
- Concomitant drug therapy showed a significant correlation with anticoagulant control (P < 0.001).
- Poor anticoagulant control was prevalent in patients using drugs that potentiate warfarin and those with frequent changes in concurrent medications. Bleeding events were associated with poor initial control (P < 0.01).
Conclusions:
- Concomitant drug interactions and frequent medication adjustments are critical factors affecting warfarin control in elderly patients.
- Close monitoring of drug interactions is essential for optimizing anticoagulant therapy and patient safety.
- The study highlights the importance of medication management in preventing complications associated with anticoagulant treatment.
Abstract:
Forty-nine patients aged 65-89 years, treated for 6 months-6 years (mean 3.9 years) over a total of 195 patient years, were studied. The efficacy of anticoagulant control or the occurrence of complications or treatment failures did not vary with the age, sex, social status, mobility, visual acuity, domiciliary supervision of medication or the indication for anticoagulation. A significant correlation was observed between the concomitant drug therapy and anticoagulant control (P less than 0.001) but not with the occurrence of complications and treatment failures. Poor anticoagulant control was observed particularly in those receiving drugs known to potentiate warfarin effect and in whom more changes were made to their concomitant drug therapy. Five patients who experienced six non-fatal haemorrhages (two major and four minor) showed poor overall anticoagulant control from the outset (P less than 0.01). The treatment failure rate was 4%.