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Point-of-care monitoring of warfarin treatment in community dwelling elderly - A randomised controlled study
Linköping University, Department of Medical and Health Sciences, Division of Health Care Analysis. Linköping University, Faculty of Medicine and Health Sciences.
Region Östergötland, Local Health Care Services in East Östergötland.
Östergötlands Läns Landsting, Local Health Care Services in East Östergötland, Department of Internal Medicine in Norrköping. Vastervik Hospital, Sweden.
Linköping University, Department of Clinical and Experimental Medicine, Division of Microbiology and Molecular Medicine. Linköping University, Faculty of Medicine and Health Sciences. Region Östergötland, Center for Diagnostics, Department of Clinical Chemistry.
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2015 (English)In: Journal of Telemedicine and Telecare, ISSN 1357-633X, E-ISSN 1758-1109, Vol. 21, no 5, 298-301 p.Article in journal (Refereed) Published
Abstract [en]

The objective of this study was to assess clinical effectiveness and costs of launching point-of-care monitoring of warfarin treatment in community dwelling frail elderly patients. A prospective multicentre controlled randomised study over 12 months comparing a point-of-care strategy with usual monitoring routines was carried out in primary healthcare centres and anticoagulation clinics in southeast Sweden. The subjects were community dwelling elderly across rural southeast Sweden on chronic warfarin treatment. Main outcome measures were time in therapeutic range (TTR), rate of treatment-related adverse events and costs. The study comprised 103 elderly people (61% women) mean age 86 yrs (range 75-98) treated with warfarin for median 9 yrs (range 1-18). Patients randomised to start point-of-care monitoring (n = 55) showed 75.9% in TTR before trial vs. 72.6% during trial (ns). The patients randomised to continue on usual monitoring routines (n = 48) showed 75.2% in TTR prior to trial vs. 72.9% during trial (ns). The point-of-care monitoring showed potential savings of SEK 624 per patient annually (based partly on effects that were not statistically significant). The study shows that point-of-care monitoring of warfarin treatment in community dwelling elderly in rural areas is as effective as usual monitoring routines and that it may offer savings to society.

Place, publisher, year, edition, pages
SAGE Publications (UK and US) , 2015. Vol. 21, no 5, 298-301 p.
National Category
Family Medicine
Identifiers
URN: urn:nbn:se:liu:diva-120279DOI: 10.1177/1357633X15574963ISI: 000357495500007PubMedID: 25766854OAI: oai:DiVA.org:liu-120279DiVA: diva2:843025
Note

Funding Agencies|FORSS; Ostergotland County Council

Available from: 2015-07-24 Created: 2015-07-24 Last updated: 2016-04-11

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Davidson, ThomasLindahl, TomasHallert, Claes
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Division of Health Care AnalysisFaculty of Medicine and Health SciencesLocal Health Care Services in East ÖstergötlandDepartment of Internal Medicine in NorrköpingDivision of Microbiology and Molecular MedicineDepartment of Clinical ChemistryDivision of Health, Activity and CareFaculty of Health SciencesLocal Health Care Services in Central Östergötland
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Journal of Telemedicine and Telecare
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