Document Detail


Optimizing the efficacy and safety of oral anticoagulant therapy: high-quality dose management, anticoagulation clinics, and patient self-management.
MedLine Citation:
PMID:  15199459     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Despite its widespread use, oral anticoagulation therapy suffers from a number of problems that lead to underuse and inadequate treatment. Problems include its narrow therapeutic index, the influence of many concomitant conditions or comorbidities, and the need for high-quality dose management. Poor management of oral anticoagulation is a prime factor influencing the occurrence of adverse events. As a result of these problems, special programs or anticoagulation management services (AMSs) have developed to manage oral anticoagulation. Such programs have demonstrated a significant improvement in outcomes compared with traditional or usual care (UC) by individual physicians. With the introduction of point-of-care prothrombin time monitors, the potential for patient self-testing and self-management has developed. Studies show the possibility of even further improvement in outcomes compared with UC, although the differences from those achieved with an AMS are less impressive.
Authors:
Jack E Ansell
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Seminars in vascular medicine     Volume:  3     ISSN:  1528-9648     ISO Abbreviation:  Semin Vasc Med     Publication Date:  2003 Aug 
Date Detail:
Created Date:  2004-06-16     Completed Date:  2004-07-15     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  100940307     Medline TA:  Semin Vasc Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  261-70     Citation Subset:  IM    
Affiliation:
Department of Medicine, Boston University Medical Center, Boston, MA, USA. jack.ansell@bmc.org
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MeSH Terms
Descriptor/Qualifier:
Administration, Oral
Anticoagulants / administration & dosage*
Drug Monitoring / methods*,  standards
Humans
Laboratories / standards
Prothrombin Time / methods
Risk Factors
Self Care / methods*
Treatment Outcome
Warfarin / administration & dosage*
Chemical
Reg. No./Substance:
0/Anticoagulants; 81-81-2/Warfarin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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