Outpatient oral anticoagulation in Poland in 2012: a single centre experience

Abstract

Oral anticoagulants reduce embolic complications in patients with atrial fibrillation (AF) and are used in the treatment and prevention of venous thromboembolism. In Poland, chronic oral anticoagulation is usually managed by primary care physicians, and the most commonly used drugs are vitamin K antagonists (VKA). To evaluate effectiveness of oral anticoagulation in 104 patients receiving chronic VKA treatment in primary care from Jan 01, 2011 to Dec 31, 2011. We performed a retrospective analysis of data of 104 patients receiving chronic VKA treatment in a primary care practice (Niepubliczny Zakład Opieki Zdowotnej ESCULAP Gniewkowo) from Jan 01, 2011 to Dec 31, 2011. These patients comprised 1.1% of the population remaining under care of this primary care practice. We determined minimum, maximum and mean values of the international normalised ratio (INR), the proportion of results within the therapeutic range, the number of INR measurements, and indications for anticoagulant treatment. In patients with AF, we determined the risks of bleeding complications and thrombotic events. Among patients receiving chronic VKA treatment, 56.84% of INR measurements were within the therapeutic range. Only 29.8% of patients had more than 70% of INR measurements within the therapeutic range. We found no association between the number of INR measurements and treatment effectiveness. The effectiveness of anticoagulation in primary care is unsatisfactory. In our study population, an acceptable time in the therapeutic range was achieved in only just below 30% of patients.