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New In Coagulation
Thursday, July 10, 2008
Computer-Assisted Dosing for Oral Anticoagulants Called Reassuringly Safe
By Crystal Phend, Staff Writer, MedPage Today
Published: June 20, 2008
Computer-assisted dose calculation tended to reduce clinical adverse events (P=0.1) and among patients on anticoagulants for deep vein thrombosis or pulmonary embolism, events were reduced 24% (P=0.001), reported Leon Poller, M.D., of the University of Manchester here, and colleagues in the June issue of the Journal of Thrombosis and Haemostasis.
In their large randomized trial, use of the computer programs also increased the time patients spent in the target anticoagulation range as measured by the International Normalized Ratio (INR) compared with doses calculated by medical staff at 32 centers in Europe, Australia, and Israel (P<0.001).
Safety is a critical issue for warfarin (Coumadin) and other blood thinners and it is difficult even for specialists to balance in the narrow therapeutic range between risk of thrombotic and bleeding events, they said.
As use of oral anticoagulants has increased, care for patients on these drugs has shifted into the community as demand has overwhelmed hospitals and clinics, the researchers noted.
The findings should be "reassuring to hospitals and community clinics wishing to move to computer-assisted dosage to reduce heavy demands on medical staff time and resources," they wrote.
Previous studies have also shown improvement in INR results with computer-assisted dosing, but none were large enough to show clinical benefit or safety, the researchers said.
Primary source:
Journal of Thrombosis and Haemostasis
Source reference:
Poller L, et al "An international multicenter randomized study of computer-assisted oral anticoagulant dosage vs. medical staff dosage" J Thromb Haemost 2008; 6: 935-943.
Donna Castellone
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