Publication: Evaluation of time in therapeutic range among patients receiving warfarin therapy: A retrospective cohort study at one private hospital in Thailand
10
0
Issued Date
2021
Resource Type
Language
eng
File Type
application/pdf
ISSN
25868195
Other identifier(s)
2-s2.0-85102523569
Rights Holder(s)
Scopus
Bibliographic Citation
Pharmaceutical Sciences Asia. Vol 48, No.2 (2021), p.107-114
Suggested Citation
Feungfu L., Raksasilp T., Swaengsak N., Chysirichote T., Santiyanon N., Yeephu S. Evaluation of time in therapeutic range among patients receiving warfarin therapy: A retrospective cohort study at one private hospital in Thailand. Pharmaceutical Sciences Asia. Vol 48, No.2 (2021), p.107-114. doi:10.29090/psa.2021.02.19.143 Retrieved from: https://hdl.handle.net/20.500.14740/8091
Abstract
The quality of warfarin therapy is often measured by the percentage oftime that a patient spends within target international normalized ratio (INR) range (time in therapeutic range, TTR). It has been found that TTR can strongly predict both bleeding and thromboembolic events. This retrospective cohort study was conducted to evaluate the meanTTR and the predictors ofinadequate anticoagulation control among subjects attending the warfarin clinic at one private hospital in Thailand during June 2012 and May 2016. Study subjects consisted of patients who had been taking warfarin for all indications with target INR 2.0-3.0. TTR was calculated through the Rosendaal method which provides the percentage of days when INR values are in desired range. A total of 196 patients (71.9% female, mean age 69.55 years) recruited represented the average TTR value of 60.46%. The stratification of patients according to anticoagulant control levels indicated that the poor control group (TTR < 65%) and the good control group (TTR ≥ 65%) contained 103 patients (52.55%) and 93 patients (47.45%), respectively. The mean TTR value of the poor control group was significantly lower than the good control group (43.64% vs. 79.09%; P < 0.001). It was found that comorbid heart failure, history of non-adherence, warfarin-drug interaction and warfarin-food/herb interaction were associated with the status of poor anticoagulant control (adjusted OR were 7.258, 18.232, 2.886 and 5.828, respectively). Recognition of these predictive factors could be beneficial in improving pharmaceutical care activities in order to optimize TTR value among patients receiving warfarin therapy. © 2021. Faculty of Pharmacy, Mahidol University (Thailand).
Subject(s)
Warfarin
Adult
Aged
Alcohol consumption
Anticoagulant therapy
Anticoagulation
Article
Atherosclerosis
Atrial fibrillation
Bleeding
Cerebrovascular accident
Cohort analysis
Comorbidity
Controlled study
Deep vein thrombosis
Drug indication
Female
Food drug interaction
Heart failure
Herb drug interaction
Human
International normalized ratio
Lung embolism
Major clinical study
Male
Medical history
Patient compliance
Pharmaceutical care
Private hospital
Retrospective study
Smoking
Thailand
Thyroid disease
Time in therapeutic range
Treatment refusal
Treatment response time
Adult
Aged
Alcohol consumption
Anticoagulant therapy
Anticoagulation
Article
Atherosclerosis
Atrial fibrillation
Bleeding
Cerebrovascular accident
Cohort analysis
Comorbidity
Controlled study
Deep vein thrombosis
Drug indication
Female
Food drug interaction
Heart failure
Herb drug interaction
Human
International normalized ratio
Lung embolism
Major clinical study
Male
Medical history
Patient compliance
Pharmaceutical care
Private hospital
Retrospective study
Smoking
Thailand
Thyroid disease
Time in therapeutic range
Treatment refusal
Treatment response time