Quality of Warfarin Use in Long-Term Care
Author Information
Author(s): Madeleine Verhovsek, Bahareh Motlagh, Mark A Crowther, Courtney Kennedy, Lisa Dolovich, Glenda Campbell, Luqi Wang, Alexandra Papaioannou
Primary Institution: McMaster University
Hypothesis
How effectively is warfarin administered to residents in long-term care facilities?
Conclusion
Warfarin control was suboptimal among long-term care residents, with many prescribed interacting medications that negatively impacted INR control.
Supporting Evidence
- 54% of the time, residents were within the therapeutic INR range.
- 79% of residents were prescribed at least one warfarin-interacting medication.
- Residents on interacting medications spent less time in the therapeutic range (53.0% vs. 58.2%).
- Quality of anticoagulation varied significantly between physicians.
Takeaway
This study looked at how well older people in nursing homes were given a blood thinner called warfarin. It found that many didn't get the right amount, especially if they were also taking other medicines that could interfere.
Methodology
A chart review of 105 residents receiving warfarin therapy in five long-term care facilities was performed, collecting data on INR levels and medication use.
Potential Biases
Potential bias due to the retrospective nature of the chart review and lack of individual consent.
Limitations
The study had a limited sample size and could not track the combined effect of interacting medications and warfarin doses on INR results.
Participant Demographics
Residents were predominantly female (72%) with a mean age of 83.6 years.
Statistical Information
P-Value
0.002
Confidence Interval
0.88 to 0.97
Statistical Significance
p=0.002
Digital Object Identifier (DOI)
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