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Computerised assistance for warfarin dosage - Effects on treatment quality

Dimberg, Ivar; Grzymala-Lubanski, Bartosz; Hagerfelth, Anette; Rosenqvist, Marten; Svensson, Peter LU and Sjalander, Anders (2012) In European Journal of Internal Medicine 23(8). p.742-744
Abstract
Background: Well-managed warfarin treatment with a high time in therapeutic range (TTR) corresponds to fewer bleedings or thromboembolic complications. Many small centres manage their warfarin dosing manually, with little or no knowledge of their treatment quality as measured by TTR. AuriculA is a Swedish National web-based anticoagulation dosing system. Our hypothesis was that the web based dosing system, compared to manual dosing, would improve the TTR. Methods: Retrospective cohort study of medical records from patients with atrial fibrillation on warfarin treatment from two centres, with previously manual warfarin dosing regimens. Data for calculation of TTR was extracted manually from medical records from the time when using manual... (More)
Background: Well-managed warfarin treatment with a high time in therapeutic range (TTR) corresponds to fewer bleedings or thromboembolic complications. Many small centres manage their warfarin dosing manually, with little or no knowledge of their treatment quality as measured by TTR. AuriculA is a Swedish National web-based anticoagulation dosing system. Our hypothesis was that the web based dosing system, compared to manual dosing, would improve the TTR. Methods: Retrospective cohort study of medical records from patients with atrial fibrillation on warfarin treatment from two centres, with previously manual warfarin dosing regimens. Data for calculation of TTR was extracted manually from medical records from the time when using manual dosing and compared with the computerised regimen. Results: In centre 1, the mean TTR was significantly increased after the introduction of AuriculA, from 64.3% (95% CI 58.8-69.8) to 71.3% (95% CI 67.7-74.8), p=0.03. In centre 2, a high TTR of 73.6% (95% CI 71.3-75.9) was maintained after the implementation, 74.0% (95% CI 71.6-76.3). INR tests were prescribed significantly more frequent after the introduction of AuriculA in both centres; 20% more often at centre 1 and 21% at centre 2. Conclusion: Computerised dosing assistance within the Swedish national quality registry AuriculA improves or maintains a high treatment quality with warfarin as measured by TTR. (C) 2012 European Federation of Internal Medicine. Published by Elsevier B. V. All rights reserved. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Anticoagulation, Warfarin, Atrial fibrillation
in
European Journal of Internal Medicine
volume
23
issue
8
pages
742 - 744
publisher
Elsevier
external identifiers
  • wos:000310577800023
  • scopus:84869085735
ISSN
1879-0828
DOI
10.1016/j.ejim.2012.07.011
language
English
LU publication?
yes
id
1f28a09f-e238-41a8-90a1-8c4eb1703550 (old id 3256241)
date added to LUP
2013-01-07 09:37:01
date last changed
2017-01-08 03:03:23
@article{1f28a09f-e238-41a8-90a1-8c4eb1703550,
  abstract     = {Background: Well-managed warfarin treatment with a high time in therapeutic range (TTR) corresponds to fewer bleedings or thromboembolic complications. Many small centres manage their warfarin dosing manually, with little or no knowledge of their treatment quality as measured by TTR. AuriculA is a Swedish National web-based anticoagulation dosing system. Our hypothesis was that the web based dosing system, compared to manual dosing, would improve the TTR. Methods: Retrospective cohort study of medical records from patients with atrial fibrillation on warfarin treatment from two centres, with previously manual warfarin dosing regimens. Data for calculation of TTR was extracted manually from medical records from the time when using manual dosing and compared with the computerised regimen. Results: In centre 1, the mean TTR was significantly increased after the introduction of AuriculA, from 64.3% (95% CI 58.8-69.8) to 71.3% (95% CI 67.7-74.8), p=0.03. In centre 2, a high TTR of 73.6% (95% CI 71.3-75.9) was maintained after the implementation, 74.0% (95% CI 71.6-76.3). INR tests were prescribed significantly more frequent after the introduction of AuriculA in both centres; 20% more often at centre 1 and 21% at centre 2. Conclusion: Computerised dosing assistance within the Swedish national quality registry AuriculA improves or maintains a high treatment quality with warfarin as measured by TTR. (C) 2012 European Federation of Internal Medicine. Published by Elsevier B. V. All rights reserved.},
  author       = {Dimberg, Ivar and Grzymala-Lubanski, Bartosz and Hagerfelth, Anette and Rosenqvist, Marten and Svensson, Peter and Sjalander, Anders},
  issn         = {1879-0828},
  keyword      = {Anticoagulation,Warfarin,Atrial fibrillation},
  language     = {eng},
  number       = {8},
  pages        = {742--744},
  publisher    = {Elsevier},
  series       = {European Journal of Internal Medicine},
  title        = {Computerised assistance for warfarin dosage - Effects on treatment quality},
  url          = {http://dx.doi.org/10.1016/j.ejim.2012.07.011},
  volume       = {23},
  year         = {2012},
}