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Patients’time in therapeutic range on warfarin among atrial fibrillation patients in Warfarin Medication Therapy Adherence Clinic

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World Journal of Cardiology 2021年第9期13卷 483-492页

作者： Siew Ling Lee Thien Jian Ong Wardati Mazlan-Kepli annuysia mageswaran Kai Hsin Tan Abdul-Muizz Abd-Malek Robert Cronshaw Department of Pharmacy Hospital SerdangMinistry of Health MalaysiaKajang 43000SelangorMalaysia Department of Cardiology Hospital SerdangMinistry of Health MalaysiaKajang 43000SelangorMalaysia College of Medical Veterinary and Life SciencesUniversity of GlasgowGlasgow G128QQUnited Kingdom

BACKGROUND The quality of warfarin therapy can be determined by the time in the therapeutic range(TTR)of international normalized ratio(INR).The estimated minimum TTR needed to achieve a benefit from warfarin therapy is≥60%.AIM To determine TTR and the predictors of poor TTR among atrial fibrillation patients who receive warfarin *** A retrospective observational study was conducted at a cardiology referral center in Selangor,Malaysia.A total of 420 patients with atrial fibrillation and under follow-up at the pharmacist led Warfarin Medication Therapeutic Adherence Clinic between January 2014 and December 2018 were ***’clinical data,information related to warfarin therapy,and INR readings were traced through electronic Hospital Information system.A data collection form was used for data *** percentage of days when INR was within range was calculated using the Rosendaal *** poor INR control category was defined as a TTR<60%.Predictors for poor TTR were further determined by using logistic *** A total of 420 patients[54.0%male;mean age 65.7(10.9)years]were *** calculated mean and median TTR were 60.6%±20.6%and 64%(interquartile range 48%-75%),*** the included patients,57.6%(n=242)were in the good control category and 42.4%(n=178)were in the poor control *** annual calculated mean TTR between the year 2014 and 2018 ranged from 59.7%and 67.3%.A high HAS-BLED score of≥3 was associated with poor TTR(adjusted odds ratio,2.525;95%confidence interval:1.6-3.9,P<0.001).CONCLUSION In our population,a high HAS-BLED score was associated with poor *** could provide an important insight when initiating an oral anticoagulant for these *** with a high HAS-BLED score may obtain less benefit from warfarin therapy and should be considered for other available oral anticoagulants for maximum benefit.

关键词： Atrial fibrillation Time in therapeutic range International normalized ratio HAS-BLED score Oral anticoagulants Warfarin Medication Therapeutic Adherence Clinic

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