Skip to main content
Top
Published in: Journal of Thrombosis and Thrombolysis 3/2009

01-04-2009

A descriptive evaluation of warfarin use in patients receiving hospice or palliative care services

Authors: Robin R. Hill, Kerri D. Martinez, Thomas Delate, Daniel M. Witt

Published in: Journal of Thrombosis and Thrombolysis | Issue 3/2009

Login to get access

Abstract

Purpose To describe and compare warfarin therapy use and outcomes between warfarin-receiving patients in hospice or palliative care (HPC) and not in HPC. Methods This retrospective, matched analysis examined warfarin-receiving patients who did (study cohort) and did not receive (control cohort) HPC services between 2002 and 2005. The matched cohorts were compared on rates of international normalized ratio (INR) measurements, INR control, and warfarin-related adverse events. Results Included were 101 and 484 study and matched control patients, respectively. Study patients had a higher mean rate of INR measurements per 30 days (2.2 ± 1.7 vs. 1.7 ± 1.4, P = 0.001) and were more likely to be above and below target INR range (P < 0.05) than control patients. Differences between the cohorts in incidences of warfarin-related adverse events were not statistically significant (P > 0.05). Conclusions Patients in HPC required more frequent INR monitoring but had similar risks for warfarin-related adverse events.
Literature
2.
go back to reference Geerts WH, Pineo GF, Heit JA et al (2004) Prevention of venous thromboembolism: the seventh ACCP conference on antithrombotic and thrombolytic therapy. Chest 126:338S–400SPubMedCrossRef Geerts WH, Pineo GF, Heit JA et al (2004) Prevention of venous thromboembolism: the seventh ACCP conference on antithrombotic and thrombolytic therapy. Chest 126:338S–400SPubMedCrossRef
3.
go back to reference Johnson MJ, Sproule MW, Paul J (1999) The prevalence and associated variables of deep venous thrombosis in patients with advanced cancer. Clin Oncol 11:105–10CrossRef Johnson MJ, Sproule MW, Paul J (1999) The prevalence and associated variables of deep venous thrombosis in patients with advanced cancer. Clin Oncol 11:105–10CrossRef
4.
go back to reference Büller HR, Agnelli G, Hull RD et al (2004) Antithrombotic therapy for venous thromboembolic disease: the seventh ACCP conference on antithrombotic and thrombolytic therapy. Chest 126:401S–428SPubMedCrossRef Büller HR, Agnelli G, Hull RD et al (2004) Antithrombotic therapy for venous thromboembolic disease: the seventh ACCP conference on antithrombotic and thrombolytic therapy. Chest 126:401S–428SPubMedCrossRef
5.
go back to reference Hull R, Pineo GF, Mah A et al (2002) A randomized trial evaluating long-term low-molecular-weight heparin therapy for three months versus intravenous heparin followed by warfarin sodium [abstract]. Blood 100,148a Hull R, Pineo GF, Mah A et al (2002) A randomized trial evaluating long-term low-molecular-weight heparin therapy for three months versus intravenous heparin followed by warfarin sodium [abstract]. Blood 100,148a
6.
go back to reference Hull R, Pineo GF, Mah A et al (2001) Safety and efficacy results for a study investigating the long-term out-of-hospital treatment of patients with proximal-vein thrombosis using subcutaneous low-molecular-weight heparin versus warfarin [abstract]. Thromb Haemost(suppl)abstract OC1647 Hull R, Pineo GF, Mah A et al (2001) Safety and efficacy results for a study investigating the long-term out-of-hospital treatment of patients with proximal-vein thrombosis using subcutaneous low-molecular-weight heparin versus warfarin [abstract]. Thromb Haemost(suppl)abstract OC1647
8.
go back to reference Singer DE, Albers GW, Dalen JE et al (2004) Antithrombotic therapy in atrial fibrillation. Chest 126:426S–456SCrossRef Singer DE, Albers GW, Dalen JE et al (2004) Antithrombotic therapy in atrial fibrillation. Chest 126:426S–456SCrossRef
9.
go back to reference Johnson MJ (1997) Problems of anticoagulation within a palliative care setting: an audit of hospice patients taking warfarin. Palliative Med 11:306–312CrossRef Johnson MJ (1997) Problems of anticoagulation within a palliative care setting: an audit of hospice patients taking warfarin. Palliative Med 11:306–312CrossRef
10.
go back to reference Noble SIR, Finlay IG (2005) Is long-term low-molecular-weight heparin acceptable to palliative care patients in the treatment of cancer related venous thromboembolism? a qualitative study. Palliative Med 19:197–201CrossRef Noble SIR, Finlay IG (2005) Is long-term low-molecular-weight heparin acceptable to palliative care patients in the treatment of cancer related venous thromboembolism? a qualitative study. Palliative Med 19:197–201CrossRef
11.
go back to reference Bergstralh EJ, Kosanke JL (1995). Computerized matching of controls. Section of Biostatistics Technical Report 56. Mayo Foundation Bergstralh EJ, Kosanke JL (1995). Computerized matching of controls. Section of Biostatistics Technical Report 56. Mayo Foundation
12.
go back to reference Naranjo CA, Busto U, Sellers EM et al (1981) A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther 30:239–245PubMedCrossRef Naranjo CA, Busto U, Sellers EM et al (1981) A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther 30:239–245PubMedCrossRef
13.
go back to reference Ansell J, Hirsh J, Poller L et al (2004) The pharmacology and management of the vitamin K antagonists. Chest 126:204S–233SPubMedCrossRef Ansell J, Hirsh J, Poller L et al (2004) The pharmacology and management of the vitamin K antagonists. Chest 126:204S–233SPubMedCrossRef
14.
go back to reference Lee AY, Levine MN, Baker RI et al (2003) Low-molecular-weight heparin versus a coumarin for the prevention of recurrent venous thromboembolism in patients with cancer. N Engl J Med 349:146–153PubMedCrossRef Lee AY, Levine MN, Baker RI et al (2003) Low-molecular-weight heparin versus a coumarin for the prevention of recurrent venous thromboembolism in patients with cancer. N Engl J Med 349:146–153PubMedCrossRef
15.
go back to reference Noble SI, Hood K, Finlay IG (2007) The use of long-term low-molecular weight heparin for the treatment of venous thromboembolism in palliative care patients with advanced cancer: a case series of sixty two patients. Palliative Med 21:473–476CrossRef Noble SI, Hood K, Finlay IG (2007) The use of long-term low-molecular weight heparin for the treatment of venous thromboembolism in palliative care patients with advanced cancer: a case series of sixty two patients. Palliative Med 21:473–476CrossRef
Metadata
Title
A descriptive evaluation of warfarin use in patients receiving hospice or palliative care services
Authors
Robin R. Hill
Kerri D. Martinez
Thomas Delate
Daniel M. Witt
Publication date
01-04-2009
Publisher
Springer US
Published in
Journal of Thrombosis and Thrombolysis / Issue 3/2009
Print ISSN: 0929-5305
Electronic ISSN: 1573-742X
DOI
https://doi.org/10.1007/s11239-008-0210-5

Other articles of this Issue 3/2009

Journal of Thrombosis and Thrombolysis 3/2009 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.