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Warfarin control in Hong Kong clinical practice: a single-centre observational study
Amy S M Lam1, Isis M H Lee1, Simon K S Mak1
1School of Pharmacy, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong.
Hong Kong Medical Journal = Xianggang Yi Xue Za Zhi
|July 31, 2020
Summary
Warfarin therapy in Hong Kong showed poor time in therapeutic range (TTR) control, impacting patient outcomes. Suboptimal patient knowledge indicates a need for improved warfarin education and management strategies.
Area of Science:
- Pharmacology and Therapeutics
- Health Services Research
- Patient Safety
Background:
- Time in therapeutic range (TTR) is crucial for warfarin efficacy and safety, assessed via the international normalized ratio (INR).
- Previous studies highlight variability in TTR and its impact on clinical and economic outcomes.
- Understanding patient knowledge is key to improving warfarin management.
Purpose of the Study:
- To evaluate TTR in Hong Kong patients using European and Japanese ranges.
- To assess the clinical and economic outcomes associated with TTR.
- To identify predictors of poor warfarin control and evaluate patient knowledge.
Main Methods:
- An observational study with retrospective and prospective components was conducted.
- Electronic patient records of 259 warfarin users were analyzed.
- Patient knowledge was assessed using the Oral Anticoagulation Knowledge (OAK) test via phone interviews.
Main Results:
- Mean TTR was 40.2% (European) vs. 49.1% (Japanese), with higher TTR in atrial fibrillation patients.
- Ideal TTR correlated with fewer complications and lower healthcare costs.
- Younger patients, and those using furosemide, famotidine, or simvastatin, had worse TTR. Mean OAK score was 54.1%, with only 13.8% achieving satisfactory scores.
Conclusions:
- Warfarin control in Hong Kong is suboptimal, irrespective of the therapeutic range used.
- Patient knowledge regarding warfarin therapy is inadequate, necessitating enhanced educational interventions.
- Improving patient education is essential for better warfarin management and outcomes.
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