Safety and Efficacy of Warfarin Therapy in Remote Communities of the Top End of Northern Australia

Jahde Dennis, William Majoni, Jeffrey Tinsley, Nadarajah Kangaharan

    Research output: Contribution to journalArticle

    Abstract

    Background: Warfarin remains a widely used anticoagulant but application in the remote context is not well documented. This study aimed to assess in more detail whether warfarin is being utilised effectively in Australia's most isolated and remote areas.

    Methods: Retrospective cohort analysis of 2013 captured international normalised ration (INR) results from people engaged in long term warfarin usage within a number of remote Northern Australian communities. Assessment of monitoring, effectiveness of dosing and complication rates was undertaken.

    Results: A cohort of 167 patients was established. On average, warfarin was utilised within therapeutic range 52% of the time. Monitoring frequency averaged 16 days. Major bleeding and thrombo-embolism occurred at rates of 5.8 and 4.1 per 100 patient years respectively.

    Conclusions: Therapeutic utilisation of warfarin in this setting is close to accepted rates but has room for improvement. Monitoring was acceptable and complication rates were not disproportionately high. This study indicates that warfarin is being used with reasonable safety and efficacy in remote regions, but further research is needed.

    Original languageEnglish
    Pages (from-to)1291-1296
    Number of pages6
    JournalHeart Lung and Circulation
    Volume26
    Issue number12
    Early online date17 Feb 2017
    DOIs
    Publication statusPublished - Dec 2017

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