Please use this identifier to cite or link to this item: http://docs.prosentient.com.au/prosentientjspui/handle/1/10911
Title: Safety and Efficacy of Warfarin Therapy in Remote Communities of the Top End of Northern Australia.
Authors: Dennis, Jahde
Majoni, William
Tinsley, Jeffrey
Kangaharan, Nadarajah
Affiliation: Department of Cardiology, Division of Medicine, Royal Darwin Hospital, Darwin, NT, Australia. Electronic address: jahde.dennis@nt.gov.au..
Department of Nephrology, Division of Medicine, Royal Darwin Hospital, Darwin, NT, Australia; Flinders University and Northern Territory Clinical School, Royal Darwin Hospital Campus, Darwin, NT, Australia..
Department of Cardiology, Division of Medicine, Royal Darwin Hospital, Darwin, NT, Australia..
Department of Cardiology, Division of Medicine, Royal Darwin Hospital, Darwin, NT, Australia; Flinders University and Northern Territory Clinical School, Royal Darwin Hospital Campus, Darwin, NT, Australia; Division of Medicine, Royal Darwin Hospital, Darwin, NT, Australia; Menzies School of Health Research, Jon Mathews Building, Royal Darwin Hospital Campus, Darwin, NT, Australia..
Issue Date: Dec-2017
Citation: Heart, lung & circulation 2017-12; 26(12): 1291-1296
Abstract: 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. Retrospective cohort analysis of 2013 captured international normalised ratio (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. 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. 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.
URI: http://docs.prosentient.com.au/prosentientjspui/handle/1/10911
DOI: 10.1016/j.hlc.2017.01.004
Type: Journal Article
Subjects: Anticoagulation
Indigenous health
International normalised ratio
Remote
Rural
Warfarin
Aged
Anticoagulants
Dose-Response Relationship, Drug
Female
Follow-Up Studies
Health Services, Indigenous
Humans
Male
Middle Aged
Morbidity
Northern Territory
Retrospective Studies
Thromboembolism
Treatment Outcome
Warfarin
Catchment Area (Health)
Rural Population
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