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

Jahde Dennis; William Majoni; Jeffrey Tinsley; Nadarajah Kangaharan

doi:10.1016/j.hlc.2017.01.004

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 journal › Article

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 language	English
Pages (from-to)	1291-1296
Number of pages	6
Journal	Heart Lung and Circulation
Volume	26
Issue number	12
Early online date	17 Feb 2017
DOIs	https://doi.org/10.1016/j.hlc.2017.01.004
Publication status	Published - Dec 2017

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Dennis, J., Majoni, W., Tinsley, J., & Kangaharan, N. (2017). Safety and Efficacy of Warfarin Therapy in Remote Communities of the Top End of Northern Australia. Heart Lung and Circulation, 26(12), 1291-1296. https://doi.org/10.1016/j.hlc.2017.01.004

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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.",

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author = "Jahde Dennis and William Majoni and Jeffrey Tinsley and Nadarajah Kangaharan",

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N2 - 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.

AB - 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.

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