Warfarin anticoagulation in the Covid-19 pandemic: Telephone-based management at a regional hematology outpatient center in Joinville, Brazil

Machado, Kendra Lys Calixto; Rosa, Suzana Tanquella da; Добнер, С. Ю.; Boettcher, Ivan Schneider; Pasqualotto, Gilberto Comarú; Lopes, Adelina Elisabeth Lehmkuhl; Araujo, Tainá de; Bolduan, Lysandra Patricia Luchtenberg; Colombo, Maria; Lacerda, Marcelo Pitombeira de

doi:10.1016/j.thromres.2021.07.006

Cited by 2 publications

(2 citation statements)

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“…Moreover, there was a remarkable reduction in the rate of intravenous infusion in 2020 (3.62%), which can be attributed to the impact of the COVID-19 pandemic. [13][14][15][16][17][18] Restriction measures imposed by hospitals and patient concerns about contracting COVID-19 resulted in decreased hospital visits. [15][16][17][18] However, the rate of intravenous infusion has since rebounded.…”

Section: Discussionmentioning

confidence: 99%

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Evaluating the Impact of Interventions and Improvements in Outpatient Intravenous Infusion Therapy at a Hospital in China: A Comprehensive Analysis of Prescription Patterns and Safety Measures

Sang,

Jiang,

Zhao

et al. 2024

RMHP

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Background The excessive use of intravenous infusion in China was once a serious problem, but in recent years, attention has been paid to the phenomenon, and the government has implemented several policies to solve the problem, which has been gradually improved. Aim This study focuses on evaluating the impact of ongoing interventions and improvements in outpatient intravenous infusion therapy. Methods From January 2016 to December 2022, we conducted a study to gather annual data on intravenous infusion prescriptions. A data questionnaire, encompassing information on departments, clinical diagnosis, and infusion drugs, was developed for this purpose. We analyzed the changing trends of Top 10 clinical departments with higher intravenous infusion usage rates and Top 10 drugs used. We also evaluated the compliance of intravenous infusion prescriptions with management regulations and drug instructions, for further intervention in the future. Results The analysis of intravenous infusion prescription rates revealed a gradual decrease from 10.89% to 5.63%. This reduction was statistically significant (P < 0.05). High levels of intravenous infusion use were consistently observed in emergency surgery and emergency medicine. Commonly administered drugs via infusion included antibacterial drugs, tumor medications, proton pump inhibitors, and injections of traditional Chinese medicine. Inappropriate prescriptions are often characterized by issues related to drug dosage, usage, indication, and selection. Trend analysis of unreasonable types revealed significant improvements in “Diagnosis incomplete/unwritten”, “Solvent selection”, “Dosing frequency”, and “Treatment without indication” (P < 0.05). Conclusion The findings of this study indicate a gradual improvement in the situation regarding intravenous infusion. However, there are still prevalent instances of unreasonable practices that need to be addressed.

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Section: Discussionmentioning

confidence: 99%

“…[13][14][15][16][17][18] Restriction measures imposed by hospitals and patient concerns about contracting COVID-19 resulted in decreased hospital visits. [15][16][17][18] However, the rate of intravenous infusion has since rebounded.…”

Section: Discussionmentioning

confidence: 99%

Evaluating the Impact of Interventions and Improvements in Outpatient Intravenous Infusion Therapy at a Hospital in China: A Comprehensive Analysis of Prescription Patterns and Safety Measures

Sang,

Jiang,

Zhao

et al. 2024

RMHP

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Virtual Education for Patient Self-Testing for Warfarin Therapy Is Effective During the COVID-19 Pandemic

Price¹,

Ansell²

2022

The Joint Commission Journal on Quality and Patient Safety

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Background Prior to the COVID-19 pandemic, warfarin users were required to complete in-person training in order to participate in approved INR patient self-testing programs (PST). To minimize in-person contact during the pandemic, a federal waiver of the in-person training requirement allowed new patients to begin PST after completing virtual training. However, it was uncertain whether such patients achieved comparable levels of International Normalized Ratio (INR) control to patients receiving in-person training. Methods INR results for patients receiving virtual training upon PST commencement between April 1, 2020 to December 31, 2020 were compared to those of patients initiating PST with in-person training between April 1, 2019 to December 31, 2019. The primary outcome was the difference in warfarin time in therapeutic range (TTR) between the groups, with secondary outcomes including differences in the percentages of INR values within individually prescribed INR range and of critical INR values. Results The records of 33,683 patients were included in the analysis (13,568 In-Person; 20,115 Virtual). Patients in the Virtual sample achieved a TTR of 66.78% as compared to the In-Person sample (64.19%; absolute difference 2.59%; CI 2.50%, 2.68%; p<0.001). The TTR values were also statistically significantly higher in all subgroups evaluated across categories of patient age, gender, geography and indication. Similarly favorable results were achieved for INR values in range and critical values. Conclusions Virtual education for PST for warfarin therapy is effective and should continue to be an option for patients and providers throughout the pandemic, and possibly beyond.

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Warfarin anticoagulation in the Covid-19 pandemic: Telephone-based management at a regional hematology outpatient center in Joinville, Brazil

Cited by 2 publications

References 9 publications

Evaluating the Impact of Interventions and Improvements in Outpatient Intravenous Infusion Therapy at a Hospital in China: A Comprehensive Analysis of Prescription Patterns and Safety Measures

Evaluating the Impact of Interventions and Improvements in Outpatient Intravenous Infusion Therapy at a Hospital in China: A Comprehensive Analysis of Prescription Patterns and Safety Measures

Virtual Education for Patient Self-Testing for Warfarin Therapy Is Effective During the COVID-19 Pandemic

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