Home medicines reviews in Australian war veterans taking warfarin do not influence International Normalised Ratio control.

Background: The clinical outcomes of warfarin are largely dependent on the international normalised ratio (INR) control achieved, and strategies to improve the time in therapeutic range (TTR) should be identified and widely implemented in practice. Aims: To investigate the influence of pharmacist-le...

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Main Authors: Bereznicki, L., van Tienen, E., Stafford, Andrew
Format: Journal Article
Published: 2015
Online Access:http://hdl.handle.net/20.500.11937/6933
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author Bereznicki, L.
van Tienen, E.
Stafford, Andrew
author_facet Bereznicki, L.
van Tienen, E.
Stafford, Andrew
author_sort Bereznicki, L.
building Curtin Institutional Repository
collection Online Access
description Background: The clinical outcomes of warfarin are largely dependent on the international normalised ratio (INR) control achieved, and strategies to improve the time in therapeutic range (TTR) should be identified and widely implemented in practice. Aims: To investigate the influence of pharmacist-led medication reviews on INR control and observe the quality of INR control in Australian veterans who take warfarin. Methods: We undertook a retrospective cohort study using administrative claims data for Australian veterans and war-widows identified by the Department of Veterans’ Affairs who were regularly dispensed warfarin and invited them to contact the research team. Pathology providers were subsequently contacted to provide INR results. Results: INR data were available for 344 of 818 (42.1%) veterans who consented to participate in the study; 64.4% were male and the median age was 83 years. The overall TTR for the veteran cohort during the study period was 64.0%. There was no difference in the TTR in the 6 months following home medicines review (HMR) compared with the control group (63.0% vs 67.0%, P = 0.27), with the TTR in patients with INR data available in the 6 months prior to, and the 6 months following HMR, remaining high (67.9% vs 69.6% P = 0.63). Approximately, one-third of veterans in this study had a percentage TTR below 60%. Conclusions: INR was well-controlled in this elderly cohort, comparable to that achieved in recent randomised trials involving warfarin. Pharmacist-led medication reviews were not associated with a change in INR control.
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spelling curtin-20.500.11937-69332019-02-19T05:35:28Z Home medicines reviews in Australian war veterans taking warfarin do not influence International Normalised Ratio control. Bereznicki, L. van Tienen, E. Stafford, Andrew Background: The clinical outcomes of warfarin are largely dependent on the international normalised ratio (INR) control achieved, and strategies to improve the time in therapeutic range (TTR) should be identified and widely implemented in practice. Aims: To investigate the influence of pharmacist-led medication reviews on INR control and observe the quality of INR control in Australian veterans who take warfarin. Methods: We undertook a retrospective cohort study using administrative claims data for Australian veterans and war-widows identified by the Department of Veterans’ Affairs who were regularly dispensed warfarin and invited them to contact the research team. Pathology providers were subsequently contacted to provide INR results. Results: INR data were available for 344 of 818 (42.1%) veterans who consented to participate in the study; 64.4% were male and the median age was 83 years. The overall TTR for the veteran cohort during the study period was 64.0%. There was no difference in the TTR in the 6 months following home medicines review (HMR) compared with the control group (63.0% vs 67.0%, P = 0.27), with the TTR in patients with INR data available in the 6 months prior to, and the 6 months following HMR, remaining high (67.9% vs 69.6% P = 0.63). Approximately, one-third of veterans in this study had a percentage TTR below 60%. Conclusions: INR was well-controlled in this elderly cohort, comparable to that achieved in recent randomised trials involving warfarin. Pharmacist-led medication reviews were not associated with a change in INR control. 2015 Journal Article http://hdl.handle.net/20.500.11937/6933 10.1111/imj.12964 fulltext
spellingShingle Bereznicki, L.
van Tienen, E.
Stafford, Andrew
Home medicines reviews in Australian war veterans taking warfarin do not influence International Normalised Ratio control.
title Home medicines reviews in Australian war veterans taking warfarin do not influence International Normalised Ratio control.
title_full Home medicines reviews in Australian war veterans taking warfarin do not influence International Normalised Ratio control.
title_fullStr Home medicines reviews in Australian war veterans taking warfarin do not influence International Normalised Ratio control.
title_full_unstemmed Home medicines reviews in Australian war veterans taking warfarin do not influence International Normalised Ratio control.
title_short Home medicines reviews in Australian war veterans taking warfarin do not influence International Normalised Ratio control.
title_sort home medicines reviews in australian war veterans taking warfarin do not influence international normalised ratio control.
url http://hdl.handle.net/20.500.11937/6933