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Anticoagulation, self-monitoring

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https://www.readbyqxmd.com/read/29709455/the-approach-to-peripartum-management-of-anticoagulation-a-multidisciplinary-survey
#1
Sagar Rohailla, Ann Kinga Malinowski, Shital Gandhi, Anne McLeod, Rosane Nisenbaum, Nadine Shehata
OBJECTIVE: This study sought to determine whether there is practice variation in the treatment and prevention of acute venous thromboembolism (VTE) in pregnant patients, potentially to prioritize future studies. BACKGROUND: The risk of VTE during pregnancy is five-fold that of the non-pregnant state. Guidance is often lacking for the treatment and prophylaxis of VTE because there are few RCTs. METHODS: The study used a cross-sectional study design using a self-administered electronic questionnaire consisting of 11 case scenarios that were sent to hematologists, maternal-fetal medicine specialists, obstetricians and gynaecologists, and internal medicine specialists across Canada...
April 27, 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/29615448/a-protocol-for-a-prospective-observational-study-using-chest-and-thumb-ecg-transient-ecg-assessment-in-stroke-evaluation-tease-in-sweden
#2
Peter Magnusson, Hirsh Koyi, Gustav Mattsson
INTRODUCTION: Atrial fibrillation (AF) causes ischaemic stroke and based on risk factor evaluation warrants anticoagulation therapy. In stroke survivors, AF is typically detected with short-term ECG monitoring in the stroke unit. Prolonged continuous ECG monitoring requires substantial resources while insertable cardiac monitors are invasive and costly. Chest and thumb ECG could provide an alternative for AF detection poststroke.The primary objective of our study is to assess the incidence of newly diagnosed AF during 28 days of chest and thumb ECG monitoring in cryptogenic stroke...
April 3, 2018: BMJ Open
https://www.readbyqxmd.com/read/29448297/anticoagulant-preferences-and-concerns-among-venous-thromboembolism-patients
#3
Pamela L Lutsey, Keith J Horvath, Lisa Fullam, Stephan Moll, Mary R Rooney, Mary Cushman, Neil A Zakai
BACKGROUND:  Warfarin and direct oral anticoagulants (DOACs) are used for the initial treatment and secondary prevention of venous thromboembolism (VTE), and have similar efficacy. Patient concerns and preferences are important considerations when selecting an anticoagulant, yet these are not well studied. METHODS:  VTE patients ( n  = 519) were surveyed from online sources (clotconnect.org, stoptheclot.org and National Blood Clot Alliance Facebook followers [ n  = 495]) and a haematology clinic in Vermont ( n  = 24)...
March 2018: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/29413611/rationally-designed-magnetic-nanoparticles-as-anticoagulants-for-blood-purification
#4
Weifeng Zhao, Qiang Liu, Xiang Zhang, Baihai Su, Changsheng Zhao
Heparin-based anticoagulant drugs are widely used for the prevention of blood clotting during extracorporeal circuit (bloodlines or cassette system) and surgical procedures as well as for the treatment of thromboembolic events. However, these anticoagulants are associated with bleeding risks that demand continuous monitoring and neutralization with antidotes. We explore the possibility of utilizing anticoagulants for blood clotting prevention, then removing them before transfusing the blood back to body, thus avoid bleeding risks...
April 1, 2018: Colloids and Surfaces. B, Biointerfaces
https://www.readbyqxmd.com/read/29391805/role-of-rivaroxaban-in-the-management-of-atrial-fibrillation-insights-from-clinical-practice
#5
REVIEW
Kavitha Vimalesvaran, Seth J Dockrill, Diana A Gorog
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia, and it leads to significant morbidity and mortality, predominantly from ischemic stroke. Vitamin K antagonists, mainly warfarin, have been used for decades to prevent ischemic stroke in AF, but their use is limited due to interactions with food and other drugs, as well as the requirement for regular monitoring of the international normalized ratio. Rivaroxaban, a direct factor Xa inhibitor and the most commonly used non-vitamin K oral anticoagulant, avoids many of these challenges and is being prescribed with increasing frequency for stroke prevention in non-valvular AF...
2018: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/29374969/prospective-comparison-of-point-of-care-device-and-standard-analyzer-for-monitoring-of-international-normalized-ratio-in-outpatient-oral-anticoagulant-clinic
#6
Bushra Moiz, Anila Rashid, Muhammad Hasan, Lena Jafri, Ahmed Raheem
Point-of-care testing (POCT) coagulometers are increasingly being used in the hospital setting and patients' self-testing. We determined the agreement of prothrombin time international normalized ratio (INR) results by POCT coagulometer and laboratory instrument through a comparative analysis and investigated whether the results of POCT coagulometer can reliably be used without being confirmed by standard laboratory analyzer. A total of 200 INR measurements by POCT coagulometer (CoaguChek XS Pro) and laboratory analyzer (Sysmex CS2000i) were compared using Passing-Bablok regression analysis and Bland-Altman plot...
January 1, 2018: Clinical and Applied Thrombosis/hemostasis
https://www.readbyqxmd.com/read/29181693/cost-effectiveness-analysis-of-patient-self-testing-therapy-of-oral-anticoagulation
#7
Sutat Kantito, Surasak Saokaew, Sukit Yamwong, Prin Vathesatogkit, Wisuit Katekao, Piyamitr Sritara, Nathorn Chaiyakunapruk
Patient Self-testing (PST) could be an option for present anticoagulation therapy monitoring, but current evidence on its cost-effectiveness is limited. This study aims to estimate the cost-effectiveness of PST to other different care approaches for anticoagulation therapy in Thailand, a low-to-middle income country (LMIC). A Markov model was used to compare lifetime costs and quality-adjusted life years (QALYs) accrued to patients receiving warfarin through PST or either anticoagulation clinic (AC) or usual care (UC)...
February 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29100941/impact-of-clinical-pharmacist-services-delivered-via-telemedicine-in-the-outpatient-or-ambulatory-care-setting-a-systematic-review
#8
REVIEW
Joshua D Niznik, Harvey He, Sandra L Kane-Gill
BACKGROUND: Utilization of telemedicine allows pharmacists to extend the reach of clinical interventions, connecting them with patients and providers, but the overall impact of these services is under-studied. OBJECTIVE: Identify the impact of clinical pharmacist telemedicine interventions on clinical outcomes, subsequently defined as clinical disease management, patient self-management, and adherence, in outpatient or ambulatory settings. METHODS: A literature search was conducted from database inception through May 2016 in Medline, SCOPUS, and EMBASE...
October 28, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/29071290/data-from-a-multidisciplinary-poll-of-178-expert-physicians-on-the-usage-of-non-vitamin-k-oral-anticoagulants-in-patients-with-atrial-fibrillation-and-venous-thromboembolism
#9
Paolo Colonna, Felicita Andreotti, Walter Ageno, Vittorio Pengo, Niccolò Marchionni
This data article contains data from a multidisciplinary questionnaires filled in by 178 expert physicians on the usage of non-vitamin K Oral Anticoagulants in patients with atrial fibrillation (AF) and for the treatment of patients with venous thromboembolism (VTE). The questionnaire consists of 9 statements of clinical complex AF and VTE cases and informative campaign on antithrombotic therapy for stroke prevention in AF. The data are potentially valuable for the scientific community, showing the doubts of different specialists (Internists, Pneumologists, Geriatricians, Cardiologists and Neurologists) with a large experience in prescribing oral anticoagulation in difficult AF and VTE cases (see full list of participants provided)...
December 2017: Data in Brief
https://www.readbyqxmd.com/read/28936235/health-literacy-and-atrial-fibrillation-relevance-and-future-directions-for-patient-centred-care
#10
Konstantinos N Aronis, Brittany Edgar, Wendy Lin, Maria Auxiliadora Parreiras Martins, Michael K Paasche-Orlow, Jared W Magnani
Atrial fibrillation (AF) is a common cardiac arrhythmia with significant clinical outcomes, and is associated with high medical and social costs. AF is complicated for patients because of its specialised terminology, long-term adherence, symptom monitoring, referral to specialty care, array of potential interventions and potential for adversity. Health literacy is a frequently under-recognised, yet fundamental, component towards successful care in AF. Health literacy is defined as the capacity to obtain, process and understand health information, and has had markedly limited study in AF...
2017: European Cardiology
https://www.readbyqxmd.com/read/28923492/rationale-and-design-of-the-atrial-fibrillation-health-literacy-information-technology-trial-af-litt
#11
Emily N Guhl, Courtney L Schlusser, Lori E Henault, Timothy W Bickmore, Everlyne Kimani, Michael K Paasche-Orlow, Jared W Magnani
BACKGROUND: Atrial Fibrillation (AF) is a common cardiac arrhythmia that is challenging for patients and adversely impacts health-related quality of life (HRQoL). Long-term management of AF requires that patients adhere to complex therapies, understand difficult terminology, navigate subspecialty care, and have continued symptom monitoring with the goal of preventing adverse outcomes. Continued interventions to ameliorate the patient experience of AF are essential. DESIGN: The Atrial Fibrillation health Literacy Information Technology Trial (AF-LITT; NCT03093558) is an investigator-initiated, 2-arm randomized clinical trial (RCT)...
November 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28869793/the-relationship-between-knowledge-health-literacy-and-adherence-among-patients-taking-oral-anticoagulants-for-stroke-thromboprophylaxis-in-atrial-fibrillation
#12
Chanelle A Rolls, Kehinde O Obamiro, Leanne Chalmers, Luke R E Bereznicki
BACKGROUND: Patients' knowledge regarding their oral anticoagulant (OAC) treatment for stroke prevention in atrial fibrillation (AF), their level of medication adherence, and health literacy are known to affect treatment outcomes. However, contemporary data regarding the relationships between these variables are lacking. OBJECTIVE: To investigate the relationships between anticoagulant knowledge, health literacy, and self-reported adherence in patients taking warfarin and the directly acting oral anticoagulants...
September 4, 2017: Cardiovascular Therapeutics
https://www.readbyqxmd.com/read/28835607/clinical-evaluation-of-whole-blood-prothrombin-time-pt-and-international-normalized-ratio-inr-using-a-laser-speckle-rheology-sensor
#13
Markandey M Tripathi, Satoru Egawa, Alexandra G Wirth, Diane M Tshikudi, Elizabeth M Van Cott, Seemantini K Nadkarni
Prothrombin time (PT) and the associated international normalized ratio (INR) are routinely tested to assess the risk of bleeding or thrombosis and to monitor response to anticoagulant therapy in patients. To measure PT/INR, conventional coagulation testing (CCT) is performed, which is time-consuming and requires the separation of cellular components from whole blood. Here, we report on a portable and battery-operated optical sensor that can rapidly quantify PT/INR within seconds by measuring alterations in the viscoelastic properties of a drop of whole blood following activation of coagulation with thromboplastin...
August 23, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28771571/optical-sensing-of-anticoagulation-status-towards-point-of-care-coagulation-testing
#14
Diane M Tshikudi, Markandey M Tripathi, Zeinab Hajjarian, Elizabeth M Van Cott, Seemantini K Nadkarni
Anticoagulant overdose is associated with major bleeding complications. Rapid coagulation sensing may ensure safe and accurate anticoagulant dosing and reduce bleeding risk. Here, we report the novel use of Laser Speckle Rheology (LSR) for measuring anticoagulation and haemodilution status in whole blood. In the LSR approach, blood from 12 patients and 4 swine was placed in disposable cartridges and time-varying intensity fluctuations of laser speckle patterns were measured to quantify the viscoelastic modulus during clotting...
2017: PloS One
https://www.readbyqxmd.com/read/28709455/barriers-and-facilitators-to-reducing-frequent-laboratory-testing-for-patients-who-are-stable-on-warfarin-a-mixed-methods-study-of-de-implementation-in-five-anticoagulation-clinics
#15
Geoffrey D Barnes, Sevan Misirliyan, Scott Kaatz, Elizabeth A Jackson, Brian Haymart, Eva Kline-Rogers, Jay Kozlowski, Gregory Krol, James B Froehlich, Anne Sales
BACKGROUND: Patients on chronic warfarin therapy require regular laboratory monitoring to safely manage warfarin. Recent studies have challenged the need for routine monthly blood draws in the most stable warfarin-treated patients, suggesting the safety of less frequent laboratory testing (up to every 12 weeks). De-implementation efforts aim to reduce the use of low-value clinical practices. To explore barriers and facilitators of a de-implementation effort to reduce the use of frequent laboratory tests for patients with stable warfarin management in nurse/pharmacist-run anticoagulation clinics, we performed a mixed-methods study conducted within a state-wide collaborative quality improvement collaborative...
July 14, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28695382/point-of-care-coagulation-monitoring-first-clinical-experience-using-a-paper-based-lateral-flow-diagnostic%C3%A2-device
#16
Michael A Hegener, Hua Li, Daewoo Han, Andrew J Steckl, Giovanni M Pauletti
Vitamin K antagonists such as warfarin are the most widely used class of oral anticoagulants. Due to a narrow therapeutic window, patients on warfarin require regular monitoring. Self-testing using point-of-care (POC) diagnostic devices is available, but cost makes this monitoring method beyond reach for many. The main objective of this research was to assess the clinical utility of a low-cost, paper-based lateral flow POC diagnostic device developed for anticoagulation monitoring without the need for a separate electronic reader...
September 2017: Biomedical Microdevices
https://www.readbyqxmd.com/read/28671441/self-monitoring-and-self-management-of-oral-anticoagulation
#17
William E Cayley
No abstract text is available yet for this article.
June 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28667866/a-case-that-illustrates-the-challenges-of-managing-pregnant-patients-with-antithrombin-deficiency-more-questions-than-answers
#18
Leslie Skeith, Andrew Aw, Julia Hews-Girard, Natalia Rydz
Using an illustrative case of a patient with antithrombin (AT) deficiency who developed a recurrent venous thromboembolism (VTE) in pregnancy despite therapeutic low-molecular-weight heparin (LMWH), we highlight what is known in the literature and address areas of controversy through a series of questions around the case. The questions we address include the role of anti-Xa monitoring for patients with past VTE on antepartum LMWH, what treatment regimen is recommended for pregnant patients who develop a recurrent VTE while on therapeutic anticoagulation, the role of antepartum AT concentrate prophylaxis, and the management of labor/delivery, epidural anesthesia and postpartum anticoagulation...
June 24, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28466601/adult-extracorporeal-membrane-oxygenation-an-international-survey-of-transfusion-and-anticoagulation-techniques
#19
S A Esper, I J Welsby, K Subramaniam, W John Wallisch, J H Levy, J H Waters, D J Triulzi, J W A Hayanga, G J Schears
BACKGROUND AND OBJECTIVES: Extracorporeal membrane oxygenation (ECMO) is a method of life support for either isolated cardiac failure or respiratory failure, with or without cardiac failure. When used for hemodynamic support, the ECMO circuit presents a non-endothelialized, artificial surface to blood inciting an inflammatory response which activates haemostatic pathways. Anticoagulation may complicate a pre-existing coagulopathy and/or inadequate surgical hemostasis of varying severity...
July 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/28386037/using-artificial-intelligence-to-reduce-the-risk-of-nonadherence-in-patients-on-anticoagulation-therapy
#20
Daniel L Labovitz, Laura Shafner, Morayma Reyes Gil, Deepti Virmani, Adam Hanina
BACKGROUND AND PURPOSE: This study evaluated the use of an artificial intelligence platform on mobile devices in measuring and increasing medication adherence in stroke patients on anticoagulation therapy. The introduction of direct oral anticoagulants, while reducing the need for monitoring, have also placed pressure on patients to self-manage. Suboptimal adherence goes undetected as routine laboratory tests are not reliable indicators of adherence, placing patients at increased risk of stroke and bleeding...
May 2017: Stroke; a Journal of Cerebral Circulation
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