Abstract
Patients under oral anticoagulant therapy (OAT) need frequent monitoring and appropriate dose adjustment. TAONet® is a computerized decision support software for OAT dose management. The study estimates the time in therapeutic range (TTR) of patients whose dose of OAT is calculated automatically by TAONet® or manually by experienced medical staff in routine clinical practice. A multicentre prospective, 6-month follow-up, observational study has been conducted in 6 Spanish healthcare centres (5 primary care, 1 hospital) and it is expected to be completed in 17 centres in Spain and Portugal. It included adult patients with an international normalized ratio (INR) therapeutic range (TR) of 2-3 or 2.5-3.5; whose OAT (warfarin or acenocoumarol) dose was managed by TAONet® (PS cohort) or manually by medical staff (PM cohort). Sociodemographic and clinical variables were collected using an electronic case report form. TTR was calculated using the Rosendaal linear interpolation method. Good control was considered when TTR≥65%. A total of 127 patients (20.8% of the estimated final sample) were included in the study [n: 60PS, 67PM; men: 61.7%PS, 55.2%PM; mean age (years): 72.3PS (SD:12.0), 65.7PM (SD:14.4); INR TR 2-3: 90.0%PS, 70.1%PM; main OAT indication: atrial fibrillation 68.3%PS, (atrial fibrillation 35.8%, valve prostheses 26.9%)PM; ≥3 comorbidities: 60%PS, 31.3%PM; mean time on current treatment (years): 8.5PS (SD:7.3), 8.5PM (SD:8.7); mean follow-up visits: 8.8PS (SD:1.7), 9.3PM (SD:3.1)]. The mean TTR was higher in the PS cohort [69.4% (SD:17.6%) vs 63.1% (SD:23.7%)]. The proportion of patients with TTR≥65% was also higher in the PS cohort (66.7% vs 46.3%). The results of the study suggest that the computer program TAONet® is a reliable instrument to calculate the OAT dosage of patients with an INR TR established on 2-3 or 2.5-3.5. Its use may help optimize OAT control and patient management in routine clinical practice.
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