Applying a Computer-based Warfarin Management System at a Large Tertiary Cardiovascular Center in Iran.

Area of Science:

• Cardiology
• Pharmacology
• Health Informatics

Background:

• Computerized warfarin management systems (WMS) are recognized as superior to experience-based methods for dosage adjustments.
• Warfarin therapy requires careful monitoring of international normalized ratio (INR) to ensure efficacy and minimize bleeding risks.

Purpose of the Study:

• To evaluate the effectiveness of a newly developed computer-based warfarin management system (WMS) in the Iranian population.
• To compare the performance of WMS against traditional experience-based warfarin management.

Main Methods:

• A computer-based WMS was developed using existing dosing algorithms and expert input at a tertiary cardiovascular center.
• The study compared the time in therapeutic range and the number of INR tests before and after WMS implementation.

Main Results:

• The mean time in therapeutic range was 57.3% before and 59% after WMS implementation.
• The mean number of INR tests decreased from 6.7 to 6.1 per patient after WMS implementation.
• Adherence to WMS recommendations was 54.5%, with lower adherence in higher INR target ranges.

Conclusions:

• The computer-based WMS demonstrated comparable efficacy to experience-based methods for INR monitoring in Iranian patients on vitamin K antagonist (VKA) anticoagulation.
• Implementation of the WMS led to a reduction in both the frequency of INR testing and the number of patient visits.