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Aims: To develop a method for evaluating the start of anticoagulation treatment in inpatients. Methods: One hundred case notes were audited using a proforma based on local guidelines in accordance with British Society for Haematology recommendations. Results: Confirmatory investigations were done in 93% and 79% of patients with symptomatic deep venous thrombosis and pulmonary embolism, respectively. Identification of patients' risk factors for anticoagulation by history taking and laboratory tests was often inadequate: baseline coagulation screen, platelet count, liver function and renal function tests were done in 52%, 95%, 70% and 87% of cases, respectively. There was a tendency to undertreat patients: 33% of the activated partial thromboplastin times (APTT) and 58% of the International Normalised Ratios (INR) were subtherapeutic. The heparin-warfarin crossover period was particularly problematic: 37% stopped heparin without an INR that day, or had an INR ofless than 2. Microscopic haematuria was monitored occasionally. Of the 62 patients continuing anticoagulation, 72% were discharged with the final INR in the therapeutic range. At discharge, only

Background: The National Antibiotic Guideline (NAG) was introduced in Malaysia in 2014, and has since become the guidance for antibiotic prescribing, especially in public health centers

The quality of anticoagulant treatment of ambulatory patients is affected by the content

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