Vitamin K-dependent anticoagulant use and level of anticoagulation control in sub-Saharan Africa: protocol for a retrospective cohort study (original) (raw)
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Gaceta de M�xico, 2021
Introduction: Vitamin K antagonists (VKA) are a therapeutic alternative in patients with venous thromboembolic disease; however, numerous factors affect their pharmacology. Objective: To evaluate the quality of VKA anticoagulation at three different time periods in Mexico. Methods: Prospective study, nested in patient cohorts at three different clinical scenarios between 2013 and 2019. Outpatients with indication for treatment with VKAs for at least 12 months were included. Patients were managed according to the criteria of the treating physician. Results: Patient general characteristics were similar between groups, except for the VKA indication. The results of 4,148 patients and 38,548 INR assessments were analyzed. The times in therapeutic range during the three phases of the study and pooled data were significantly higher for the anticoagulation clinic. Only the number of patient visits was significantly associated with the results, unlike age, gender, and type of VKA. Conclusions: VKAs are widely used, but it is difficult for therapeutic goals to be achieved, especially in non-specialized clinical services. Creation of anticoagulation clinics is an urgent need for the Mexican health system.
INCREASING PRESCRIPTON OF NEW NON VITAMIN K DEPENDENTS ANTICOAGULANTS FOLLOWING THEIR INTRODUCTION
Objectives: To study and analyse the increase in prescripng the new Non vitamin K dependents anticoagulants in two main hospitals of the Royal Medical Services of Jordan from the date of their first introduction in May 2016. Method: A retrospective study to measure the dispensed quantities of both old oral anticoagulants and new non vitamin K dependents anticoagulants and calculating number of patients started using anticoagulants depending on the records of out patient pharmacies in King Hussein hospital and Queen Alia center for cardiology within the period between May 2016 to January 2019. Results: the results showed a significant increase in number of patients using newly introduced non vitamin K dependent oral anticoagulants associated with decrease in the use of old oral anticoagulants. Conclusion: The increased proportions of the number of patients converted from old oral anticoagulants to newly introduced oral non vitamin K dependents anticoagulants reflects an increase in tendency toward using these types of oral anticoagulants in Royal medical services of Jordan although this may increase the direct cost of anticoagulation therapy.
British Journal of Clinical Pharmacology, 2021
Warfarin has existed for >7 decades and has been the anticoagulant of choice for many thromboembolic disorders. The recent introduction of direct-acting oral anticoagulants (DOACs) has, however, caused a shift in preference by healthcare professionals all over the world. DOACs have been found to be at least as effective as warfarin in prevention of stroke in patients with atrial fibrillation and in treatment of venous thromboembolism. In sub-Saharan Africa, however, the widespread use of DOACs has been hampered mainly by their higher acquisition costs. As the drugs come off patent, their use in sub-Saharan Africa is likely to increase. However, very few trials have been conducted in African settings, and safety concerns will need to be addressed with further study before widespread adoption into clinical practice.
Internal and emergency medicine, 2017
Vitamin K antagonists (VKA) are the most widely used anticoagulants in the world. An appropriate management of treated patients is crucial for their efficacy and safety. The prospective, observational, multicenter, inception-cohort FCSA-START Register, a branch of START Register (NCT02219984) included VKA-treated patients managed by centers of Italian Federation of anticoagulation clinics (AC). Baseline patient characteristics and data during treatment were analyzed and compared with those of ISCOAT study, performed by the Federation and published in 1996/7. 5707 naïve patients [53% males, mean age 73.0 years (28.1% >80 years)], 61.6% treated for atrial fibrillation (AF), and 28.0% for venous thromboembolism were included. During the 8906 patient-years (pt-yrs) of observation, 123 patients had major bleeding (MB) (1.38% pt-yrs; fatal: 0.11% pt-yrs), while non-major clinically relevant bleeds were 144 (1.62% pt-yrs). Bleeding was more frequent in elderly (≥70 years; p = 0.04), and...
Suboptimal use of non-vitamin K antagonist oral anticoagulants
Medicine, 2016
This study aimed to investigate the potential misuse of novel oral anticoagulants (NOACs) and the physicians' adherence to current European guideline recommendations in real-world using a large dataset from Real-life Multicenter Survey Evaluating Stroke Prevention Strategies in Turkey (RAMSES Study). RAMSES study is a prospective, multicenter, nationwide registry (ClinicalTrials.gov identifier NCT02344901). In this subgroup analysis of RAMSES study, patients who were on NOACs were classified as appropriately treated (AT), undertreated (UT), and overtreated (OT) according to the European Society of Cardiology (ESC) guidelines. The independent predictors of UT and OT were determined by multivariate logistic regression.
Background: Anticoagulation is an essential lifesaving management practice indicated for Arterial, venous and intracardiac thromboembolism. The use of anticoagulants must follow recommended guidelines ;Otherwise it is Fraught with increased morbidity and mortality. Objective: This study is undertaken to examine the utilization patterns of anticoagulation services in Adama hospital and medical college in medical ward. Methods: Retrospective study will be conducted to assess data from folders of subjects on anticoagulation and monitoring in Adama hospital medical college at patients in medical ward. Hospitalized patients who received anticoagulation agent from January 1 to December 31, 2015 at medical ward of AHMC . The study will be conducted from
Journal of basic and clinical pharmacy, 2017
Background: Anticoagulants are drugs used to prevent thrombus extension and embolic complications by reducing the rate of fibrin formation. In a hospital setting anticoagulants are mainly used for the different indications; however, both under-anticoagulation and over-anticoagulation may expose the patient to different problems. The objective of this study was to assess the utilization patterns of anticoagulants at medical ward of Hiwot Fana Specialized University Hospital (HFSUH). Methods: A retrospective study was conducted at Medical Ward of HFSUH from Medical record of patients’ who take anticoagulants from March 30, 2014 to March 30, 2016. The study was conducted from April 1 to May 10, 2016. Results: A total of 87 patients over a period of 2 years were on anticoagulant and laboratory monitoring done in HFSUH. More females were on anticoagulant and monitoring. The anticoagulants used were unfractionated heparin, low-molecular weight heparins and warfarin. The most common clinic...
The African Journal of Pharmacology and Therapeutics, 2017
Background : Local anticoagulation services are inadequate and substantially underutilized despite compelling evidence showing that their appropriate use significantly reduces the risk of thromboembolic complications. Objectives : To determine the predictors of adequate ambulatory anticoagulation services in Kenyatta National Hospital. Methodology : A cross sectional study between December 2014 and April 2015 among 102 adult outpatients on anticoagulation using consecutive sampling was done. Information abstracted into a predesigned data collection tool included participants’ sociodemographic characteristics, regular sources of supply of anticoagulant, clinic pre-appointment reminders, indications of treatment and international normalized ratio tests. Data were analyzed using IBM Statistical Package for Social Sciences version 21.0 and logistic regression was used to determine independent predictors of adequate anticoagulation, which was defined as international normalized ratio ran...