Abstract | BACKGROUND: OBJECTIVE: To examine the feasibility of the Moi Teaching and Referral Hospital anticoagulation monitoring service and compare its performance with clinics in resource-rich settings. METHODS: A retrospective chart review compared the percentage time in the therapeutic range (TTR) and rates of bleeding and thromboembolic events to published performance targets using the inference on proportions test. Wilcoxon's rank sum analyses were used to establish predictors of TTR. RESULTS: For the 178 patients enrolled, the mean TTR was 64.6% whereas the rates of major bleeds and thromboembolic events per year were 1.25% and 5%, respectively. In the primary analysis, no statistically significant differences were found between the results of TTR, major bleeds and thromboembolic events for the clinic and published performance rates. In the secondary analysis, having an artificial heart valve and a duration of follow-up of > 120 days were positively associated with a higher TTR (P < 0.05) whereas venous thromboembolism, history of tuberculosis, HIV and a duration of follow-up of < 120 days were associated with having a lower TTR (P < 0.05). CONCLUSIONS: The performance of the MTRH anticoagulation clinic is non-inferior to published metrics on the performance of clinics in resource-rich settings.
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Authors | I Manji, S D Pastakia, A N DO, M N Ouma, E Schellhase, R Karwa, M L Miller, C Saina, C Akwanalo |
Journal | Journal of thrombosis and haemostasis : JTH
(J Thromb Haemost)
Vol. 9
Issue 11
Pg. 2215-20
(Nov 2011)
ISSN: 1538-7836 [Electronic] England |
PMID | 21914124
(Publication Type: Evaluation Study, Journal Article, Research Support, Non-U.S. Gov't)
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Copyright | © 2011 International Society on Thrombosis and Haemostasis. |
Chemical References |
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Topics |
- Anticoagulants
(therapeutic use)
- Drug Monitoring
- Health Resources
(economics, standards, statistics & numerical data)
- Humans
- Kenya
- Pharmacists
(economics, standards)
- Retrospective Studies
- Rheumatic Heart Disease
- Rural Population
- Venous Thromboembolism
(drug therapy, epidemiology)
- Warfarin
(therapeutic use)
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