Numerous randomized controlled trials (RCTs) have conclusively demonstrated that long-term anticoagulation in patients with nonvalvular atrial fibrillation (NVAF) can reduce the risk of stroke by approximately 68% per year, with a low annual risk of major hemorrhage (1.3%). Despite these impressive results, several studies have shown that the use of warfarin in the “real world” for the preventi...

Patients on warfarin and their physicians must constantly balance the risks of bleeding and clotting. We offer practical tips for safe and effective warfarin therapy, based on the practices of the Anticoagulation Clinic of The Cleveland Clinic.

Variable warfarin response during treatment initiation poses a significant challenge to providing optimal anticoagulation therapy. We investigated the determinants of initial warfarin response in a cohort of 167 patients. During the first nine days of treatment with pharmacogenetics-guided dosing, S-warfarin plasma levels and international normalized ratio were obtained to serve as inputs to a ...

BACKGROUND Studies of selected populations suggest that anticoagulation in atrial fibrillation is underused and that nonclinical factors influence the use of this stroke-preventing therapy. We wished to examine recent national trends and predictors of warfarin sodium use in atrial fibrillation. METHODS AND RESULTS A nationally representative sample of office visits from the 1989 to 1996 Natio...

OBJECTIVE To explore the barriers to warfarin use from the perspective of nurses working in aged care. DESIGN A qualitative study, involving a semi-structured group interview, during March-April 2001. SETTING AND SUBJECTS Eleven nurses, employed within the catchment of the Northern Sydney Area Health Service, who were involved in the care of elderly warfarinised patients. MAIN OUTCOME MEA...

We are presenting a 72-year-old female who was admitted to hospital with deep vein thrombosis (DVT). She was known to have atrial fibrillation and was initiated on warfarin for stroke prophylaxis 3 days earlier. She was given warfarin therapy without low molecular weight heparin cover as per "slow-start regimen" protocol. The warfarin dose was increased after 3 days to achieve rapid anticoagula...

he term warfarin resistance is usually reserved for patients who require warfarin in excess of 20 mg/day to maintain the International Normalized Ratio (INR) within the therapeutic range. It is usually encountered at the start of therapy, however, it may also occur in patients who have been already on warfarin therapy. Both diet and the co-administration of certain drugs can have a marked effec...

OBJECTIVE To identify potential weaknesses in the system of managing warfarin therapy. DESIGN, PARTICIPANTS AND SETTING A structured interview-based study of 40 community-dwelling patients taking warfarin and with an international normalised ratio > or = 6.0 and 36 of their treating doctors (35 general practitioners and 1 specialist), conducted between July and November 2007. Patients all rec...

OBJECTIVE To review the challenges of warfarin education for older patients (aged 65 years or older) in terms of knowledge, access to warfarin education, and education resources. METHODS A quasi-systematic review of the literature was performed via electronic database searches (eg, Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, International Pharmaceutical Abstract...

Although bucolome has been used empirically to enhance and stabilize warfarin action in some institutes, the clinical risks and benefits of this combination are unclear. In the present study, warfarin monotherapy (WM) and bucolome combination (BC) therapy were compared in anticoagulation therapy.One hundred and ninety-five patients indicated for anticoagulation therapy were randomly assigned to...