Following evidence of clinical benefit in non-rheumatic atrial fibrillation,1 increasing numbers of patients with cardiac conditions are being referred to outpatient anticoagulant clinics, necessitating review of existing services.2 In one anticoagulant clinic in a north London hospital the number of new patients referred increased by 27% and clinic attendances by 77% between 1991 and 1993. Methods for managing this increase have been reported,2 3 but we have developed a system which can operate within existing resources by selecting patients requiring consultation with a clinic doctor. A weekly anticoagulant clinic was administered by a phlebotomist with the help of two health care assistants, and all patients were seen by the clinic doctors (a consultant haematologist and a registrar) for dosing and counselling. In 1991 a …
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