Comparisons of methods and outcomes of warfarin guideline-based management in patients on warfarin therapy whose international normalized ratio (Inr) is higher than target inr at vachiraphuket hospital

Abstract

Objective: To compare the methods and management outcomes based on the warfarin guidelines of Vachiraphuket Hospital in patients receiving warfarin whose international normalized ratio (INR) is higher than target INR at Vachira-phuket Hospital. Material and Methods: Retrospective analytic studies were conducted. The data were collected from retrospective outpatient medical records from 1st January 2012-9th September 2016. Results: Sixty-seven patients with a total number of 178 events of INR higher than the target were reported. All events were divided into 84 events and 94 events which dealt and did not deal with the management method according to the warfarin guidelines of Vachiraphuket Hospital, respectively. After treating patients based on the hospital management guidelines, 33 events (39.3%) achieved target INR and 51 events (60.7%) were out of the target INR range. In the cases of patients who were not treated based on the hospital guidelines, 39 events (41.5%) were in the target INR and 55 events (58.5%) were out of INR range. Comparing the management methods and their outcomes, there was no statistically significant difference in achieving target INR between the patients treated with the hospital guideline-based method or the non-guideline-based method (odds ratio=0.913, p-value=0.765). Conclusion: According to the warfarin guidelines of Vachiraphuket Hospital, the management for patients with INR higher than target INR was probably unsuccessful for everyone. Therefore, the management of each individual patient should be carefully considered. © 2018, Prince of Songkla University. All rights reserved.