Monitoring the effectiveness of anticoagulation control
International Journal of Health Care Quality Assurance
ISSN: 0952-6862
Article publication date: 1 January 2005
Abstract
Purpose
To assess the quality of anticoagulation control at an out‐patient clinic and to investigate patterns of deviation from therapeutic ranges.
Design/methodology/approach
Records for 36,157 clinic visits (2,050 patients) were studied. The quality of anticoagulation control was assessed by comparing the measurement of pro‐thrombin time recorded at each clinic visit, expressed as an international normalised ratio (INR), with the target therapeutic range for that patient, also recorded at the time of the clinic visit. Each INR measurement was classified according to the relevant patient's therapeutic range and the signed difference between the INR measurement and the centre of the therapeutic range was calculated. For each patient the percentage of their INR measurements that lay within their therapeutic range was calculated.
Findings
Of the measurements, 52.3 per cent were within the relevant therapeutic range. The proportion of individual patients' INR measurements within range varied greatly (median 52 per cent, inter‐quartile range 40‐65 per cent). The quality of anticoagulation control, as measured by the proportion of patients within their therapeutic range, changed little with patient follow‐up time.
Originality/value
The quality of anticoagulation control reported is comparable with that at other centres. The vast majority of patients spend periods outside the therapeutic range for their condition. There may be considerable room for improvement.
Keywords
Citation
Utley, M., Patterson, D. and Gallivan, S. (2005), "Monitoring the effectiveness of anticoagulation control", International Journal of Health Care Quality Assurance, Vol. 18 No. 1, pp. 7-14. https://doi.org/10.1108/09526860510576929
Publisher
:Emerald Group Publishing Limited
Copyright © 2005, Emerald Group Publishing Limited