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https://www.readbyqxmd.com/read/28314139/patients-experiences-of-atrial-fibrillation-and-non-vitamin-k-antagonist-oral-anticoagulants-noacs-and-their-educational-needs-a-qualitative-study
#1
Danielle E Clarkesmith, Gregory Y H Lip, Deirdre A Lane
PURPOSE: Qualitative research on atrial fibrillation (AF) patient's experiences and perceptions of taking the non-vitamin K antagonist oral anticoagulants (NOACs) for stroke prevention is limited. This study explores patients' experiences of dabigatran and their recommendations for development of educational materials. PATIENTS AND METHODS: Semi-structured individual interviews with 8 warfarin-naive and 8 warfarin-experienced AF patients, using qualitative deductive thematic analysis...
March 7, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28274053/dentists-knowledge-attitude-and-practice-in-treating-patients-taking-oral-antithrombotic-medications-a-survey
#2
Ravindran Chinnaswami, Ritvi K Bagadia, Anusha Mohan, Eswar Kandaswamy, Deepak Chandrasekaran
INTRODUCTION: India lists high on patients suffering from diabetes, hypertension, stroke and myocardial infarction. Hence, a large proportion of the population is on long term Oral Antithrombotic Medications (OAM). Though several guidelines exist on dental management of these patients, previous surveys have shown variation among the dentists. AIM: The purpose of this study was to assess the knowledge, attitude and practice of dentists in Chennai, India, towards dental management of patients taking OAM using a questionnaire survey...
January 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28259509/early-antithrombotic-treatment-with-warfarin-oral-suspension-in-severe-neonatal-protein-c-deficiency
#3
C Milleret, C Epiard, S Douchin, G Pernod, T Debillon
Neonatal severe protein C deficiency is a serious disease. There is no uniform approach for long-term preventive treatment of thrombotic events. We report the case of neonatal severe protein C deficiency treated with warfarin oral suspension. An international normalized ratio (INR) from 2.5 to 3.5 was expected. The INR was measured by home monitoring using the Coaguchek XS(®) (Roche Diagnostics, Mannheim, Germany) monitor. During 2years of warfarin treatment, there were only two minor episodes of purpuric access and no bleeding was reported...
March 1, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28237982/associations-between-ischemic-stroke-follow-up-socioeconomic-status-and-adherence-to-secondary-preventive-drugs-in-southern-sweden-observations-from-the-swedish-stroke-register-riksstroke
#4
Teresa Ullberg, Eva-Lotta Glader, Elisabet Zia, Jesper Petersson, Marie Eriksson, Bo Norrving
BACKGROUND: Currently, the knowledge that one has on adequate stroke follow-up practices is limited. We report associations between 90-day stroke follow-up, socio-economy and adherence to secondary prevention in southern Sweden. METHODS: Data on 5,602 patients with ischemic stroke January 1, 2008-December 31, 2010, were obtained from Riksstroke and linked to official registers for information on education, birth country, doctor's follow-ups, and secondary prevention...
February 25, 2017: Neuroepidemiology
https://www.readbyqxmd.com/read/28231618/the-patients-perspective-of-inr-self-testing-remote-communication-of-test-results-and-confidence-to-move-to-self-management
#5
Anne Grogan, Michael Coughlan, Geraldine Prizeman, Niamh o'Connell, Nora O'Mahony, Katherine Quinn, Gabrielle McKee
AIM: The aim of this study was to elicit the perceptions of patients, who self-tested their INR and communicated their results via a text or phone messaging system, to determine their satisfaction with the education and support that they received and to establish their confidence to move to self-management. BACKGROUND: Self-testing of INR has been shown to be reliable and is fast becoming common practice. As innovations are introduced to point of care testing, more research is needed to elicit patients' perceptions of the self-testing process...
February 23, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28187730/adherence-to-treatment-guidelines-the-association-between-stroke-risk-stratified-comparing-chads2-and-cha2ds2-vasc-score-levels-and-warfarin-prescription-for-adult-patients-with-atrial-fibrillation
#6
Scott A Chapman, Catherine A St Hill, Meg M Little, Michael T Swanoski, Shellina R Scheiner, Kenric B Ware, M Nawal Lutfiyya
BACKGROUND: Ischemic stroke is a risk associated with atrial fibrillation (AF) and is estimated to occur five times more often in afflicted patients than in those without AF. Anti-thrombotic therapy is recommended for the prevention of ischemic stroke. Risk stratification tools, such as the CHADS2, and more recently the CHA2DS2-VASc, for predicting stroke in patients with AF have been developed to determine the level of stroke risk and assist clinicians in the selection of antithrombotic therapy...
February 11, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28184172/practically-prepared-pre-intern-student-views-following-an-education-package
#7
Susan McKenzie, Craig Mellis
BACKGROUND: Graduating medical students enter their internship with varied levels of practical experience in procedural skills. To address this problem, many medical schools have introduced intensive skill training courses immediately prior to graduation. This study examines the impact of a pre-intern (PrInt) education package, consisting of a short intensive course, followed by a one-month clinical attachment. METHODS: In September 2014, all PrInt students (n = 53) at the Central Clinical School (Sydney, NSW, Australia) attended three days of intensive training...
2017: Advances in Medical Education and Practice
https://www.readbyqxmd.com/read/28096031/the-effect-of-nurse-led-care-on-stability-time-in-therapeutic-range-of-inr-in-ischemic-stroke-patients-receiving-warfarin
#8
Mina Amiri, Marzieh Kargar, Afshin Borhanihaghighi, Fahimeh Soltani, Najafe Zare
PURPOSE: The current study is designed in order to investigate the effect of nurse-led care (the supportive and educational measurements by nurses) on stability time in therapeutic range of INR in ischemic stroke patients receiving Warfarin. METHOD: In this quasi-experimental study, 80 ischemic stroke patients were investigated, 40 patients in experimental group and 40 in the control group referred to the nurse-based warfarin clinics affiliated to Shiraz University of Medical Sciences...
February 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28074382/engaging-hmong-adults-in-genomic%C3%A2-and%C3%A2-pharmacogenomic-research-toward-reducing-health-disparities-in-genomic-knowledge-using-a-community-based-participatory-research-approach
#9
Kathleen A Culhane-Pera, Robert J Straka, MaiKia Moua, Youssef Roman, Pachia Vue, Kang Xiaaj, May Xia Lo, Mai Lor
Advancing precision medicine relies in part on examining populations that may exhibit unique genetic variants that impact clinical outcomes. Failure to include diverse populations in genomic-based research represents a health disparity. We implemented a community-based participatory research (CBPR) process with the Hmong community in Minnesota, who were refugees from Laos, in order to assess the feasibility of conducting genomic and pharmacogenomic-based research for genetic variants that are relevant to the Hmong community...
January 10, 2017: Journal of Community Genetics
https://www.readbyqxmd.com/read/27998809/explaining-and-reducing-the-variation-in-inter-laboratory-reported-values-for-international-normalised-ratio
#10
Roslyn Bonar, Emmanuel J Favaloro
INTRODUCTION: Monitoring of vitamin K antagonist (VKA) therapy is usually achieved using the International Normalised Ratio (INR). However, despite international standardisation, there remains considerable concern regarding ongoing high levels of inter-laboratory variation, as generated by different laboratories using the same homogeneous plasma sample. Notably, significant discrepancies continue to be evidenced in external quality assessment (EQA) environments, prompting additional investigations to determine causes and to identify potential inconsistencies of practice...
February 2017: Thrombosis Research
https://www.readbyqxmd.com/read/27925424/evaluation-of-an-institutional-project-to-improve-venous-thromboembolism-prevention
#11
REVIEW
Christina A Minami, Anthony D Yang, Mila Ju, Eckford Culver, Kathryn Seifert, Lindsey Kreutzer, Terri Halverson, Kevin J O'Leary, Karl Y Bilimoria
BACKGROUND: Northwestern Memorial Hospital (NMH) was historically a poor performer on the venous thromboembolism (VTE) outcome measure. As this measure has been shown to be flawed by surveillance bias, NMH embraced process-of-care measures to ensure appropriate VTE prophylaxis to assess healthcare-associated VTE prevention efforts. OBJECTIVE: To evaluate the impact of an institution-wide project aimed at improving hospital performance on VTE prophylaxis measures...
December 2016: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/27905076/improvement-of-time-in-therapeutic-range-with-warfarin-by-pharmaceutical-intervention
#12
Alvaro Víquez-Jaikel, Victoria Hall-Ramírez, Allan Ramos-Esquivel
Background Anticoagulation therapy with warfarin is highly effective for prevention and treatment of thromboembolic disorders. Nevertheless, its management is challenging especially in developing countries, where the medical access is difficult and patient education is poor. Objective To determine the effect of pharmaceutical intervention (PI) on the time in therapeutic range (TTR) of a group of anticoagulated patients from our referral center. Method A group of consecutive outpatients previously treated by usual medical care underwent PI...
February 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/27864202/implementation-of-inpatient-models-of-pharmacogenetics-programs
#13
Larisa H Cavallari, Craig R Lee, Julio D Duarte, Edith A Nutescu, Kristin W Weitzel, George A Stouffer, Julie A Johnson
PURPOSE: The operational elements essential for establishing an inpatient pharmacogenetic service are reviewed, and the role of the pharmacist in the provision of genotype-guided drug therapy in pharmacogenetics programs at three institutions is highlighted. SUMMARY: Pharmacists are well positioned to assume important roles in facilitating the clinical use of genetic information to optimize drug therapy given their expertise in clinical pharmacology and therapeutics...
December 1, 2016: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27857237/improving-the-use-and-timeliness-of-anticoagulation-reversal-for-warfarin-related-intracranial-haemorrhage
#14
Carl Hanger, John Geddes, Tim Wilkinson, Michele Lee, Scott Pearson, Andrew Butler, Krishna Badami
BACKGROUND: Warfarin-related intracranial haemorrhage (WRICH) is a life-threatening complication of warfarin use. Rapid and complete reversal of the coagulopathy is required. Reversal protocols which include prothrombin complex concentrates (PCC) are now recommended. We report on a quality improvement project to implement and refine such a protocol. METHODS: Retrospective and then prospective audits of all WRICH patients presenting to a single centre. The protocol development and subsequent refinements are described...
November 18, 2016: New Zealand Medical Journal
https://www.readbyqxmd.com/read/27729677/risk-factors-for-bleeding-in-hospitalized-patients-with-elevated-inr-no-vitamin-k-therapy-received-versus-vitamin-k-received
#15
Monique Mounce, Candace Essel, Tiffany Kim, Che Matthew Harris
BACKGROUND: Supratherapeutic international normalized ratio (INR) in patients on warfarin is a common side effect. Updated guidelines recommend against using vitamin K to correct INRs 4.5 to 10 in the absence of bleeding. The impact of compliance with updated guidelines during hospitalization has not been fully explored. METHODS: A retrospective, observational study was performed utilizing electronic medical records. The goal was to evaluate management of supratherapeutic INR values for medicine inpatients and identify differences in clinical outcomes among inpatients treated and not treated with vitamin K...
November 2015: Hospital Pharmacy
https://www.readbyqxmd.com/read/27704588/assessment-of-web-based-education-resources-informing-patients-about-stroke-prevention-in-atrial-fibrillation
#16
E Pandya, B V Bajorek
WHAT IS KNOWN AND OBJECTIVE: The importance of 'shared decision-making' is much emphasized in recent clinical guidelines regarding stroke management in atrial fibrillation (AF), more so following the inclusion of non-vitamin K oral anticoagulants (NOACs) among the treatment options. It is important that patients are navigated through balanced and unbiased information about the available treatment options, so as to understand the risk and benefits associated with the therapies, and to enable them to accordingly communicate their concerns and views with their clinicians prior to therapy selection...
December 2016: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/27693910/is-the-clinical-relevance-of-drug-food-and-drug-herb-interactions-limited-to-grapefruit-juice-and-saint-john-s-wort
#17
Stéphane Mouly, Célia Lloret-Linares, Pierre-Olivier Sellier, Damien Sene, J-F Bergmann
An interaction of drug with food, herbs, and dietary supplements is usually the consequence of a physical, chemical or physiologic relationship between a drug and a product consumed as food, nutritional supplement or over-the-counter medicinal plant. The current educational review aims at reminding to the prescribing physicians that the most clinically relevant drug-food interactions may not be strictly limited to those with grapefruit juice and with the Saint John's Wort herbal extract and may be responsible for changes in drug plasma concentrations, which in turn decrease efficacy or led to sometimes life-threatening toxicity...
September 28, 2016: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
https://www.readbyqxmd.com/read/27688671/quality-of-anticoagulation-control-among-patients-with-atrial-fibrillation-an-experience-of-a-tertiary-care-center-in-saudi-arabia
#18
Sarah M Alyousif, Ahmed A Alsaileek
BACKGROUND: Atrial fibrillation (AF) is the most common chronic rhythm disorder. Patients with AF are at an increased risk of ischemic stroke. Therefore, optimal anticoagulation is essential to reduce the risk of stroke. The aim of this study was to assess the level of anticoagulation control achieved in patients with nonvalvular AF receiving medical care in a tertiary care hospital. METHODS: This was a retrospective cohort study in ambulatory care clinics at tertiary care hospital in Saudi Arabia...
October 2016: Journal of the Saudi Heart Association
https://www.readbyqxmd.com/read/27441538/assessment-of-warfarin-treatment-efficacy-by-means-of-using-coagulation-test-results-within-the-therapeutic-range
#19
P Varim, C Varim, H Ergenç, M Uyanık, S Yaylacı, M Vatan, H Gündüz
Time in Therapeutic Range (TTR) is a value used to assess the efficacy of Warfarin treatment. The aim of our study is to determine the effective INR levels and the rate of TTR in patients on Warfarin regimen due to Atrial Fibrillation (AF) or Mechanical Prosthetic Valve (MPV). A total of 94 patients (58 female, and 36 male, mean age: 64.9±11years) on Warfarin treatment due to AF or MPV with at least 10 INR levels measurements in the last 6 months were included in this retrospective study. The patients were divided into 2 groups...
June 2016: Georgian Medical News
https://www.readbyqxmd.com/read/27342960/assessment-of-psychometric-properties-of-the-brazilian-version-of-the-oral-anticoagulation-knowledge-test
#20
Marcus Fernando da Silva Praxedes, Mauro Henrique Nogueira Guimarães de Abreu, Saul Martins Paiva, Juliana Vaz de Melo Mambrini, Milena Soriano Marcolino, Maria Auxiliadora Parreiras Martins
BACKGROUND: The aim of this study was to evaluate the psychometric properties of the Brazilian version of the Oral Anticoagulation Knowledge (OAK) Test. METHODS: This study, conducted in an anticoagulation clinic, included 201 Brazilian participants aged over 18 years, who had been using warfarin for more than two months. The reliability of the instrument was evaluated by assessing internal consistency (Kuder-Richardson coefficient) and reproducibility (test-retest reliability)...
June 24, 2016: Health and Quality of Life Outcomes
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