Specialized software in the management of anticoagulant therapy network in the Republic of Tatarstan

Close metadata

Cardiovascular diseases are the leading cause of death in the Russian Federation. Early and effective treatment increases life expectancy and quality of life. Vitamin K antagonists (VKAs) reduce the thrombosis risk in certain patients. In 2018, in the Republic of Tatarstan (RT), an anticoagulant therapy network to monitor coagulation parameters and proper dosing of the drugs was organized, considering the potential risks inherent to this drug group.

OBJECTIVE

To assess the efficacy of the PT anticoagulant therapy network using monitoring of coagulation parameters and VKAs dosing.

MATERIALS AND METHODS

Specialized software «Anticoagulation» was used to organize the activity of the anticoagulant network, which ensures the network functioning and monitoring of coagulation parameters and VKAs dosing. Training for physicians involved in international normalized ratio (INR) monitoring was performed, and patient schools were organized.

RESULTS

Between 2018 and 2019, 4.076 patients taking VKAs were registered in the Anticoagulation program, and 30.431 INR tests were performed. It was shown that the vast majority of patients taking warfarin have atrial fibrillation (51.6% of all patients), followed by patients with artificial heart valves (39.5%), venous thrombosis of various localizations (5.3%), and pulmonary hypertension (0.4%), etc. Time in therapeutic range as a key performance indicators of monitoring efficacy for this patient group increased from 60 to 67% between 2018 and 2019. The average time between INR tests increased from 24 days in 2018 to 26 days in 2019. Complications were recorded in 1.5% of cases, and all of them were mild gingival, time-limited nasal, and subcutaneous bleeding. No mortality or urgent hospital admission due to incorrect dosage of warfarin was reported.

CONCLUSION

The effectiveness of the RT anticoagulant therapy network for patient monitoring and AVK dosing using specialized software was demonstrated. The Anticoagulation software module is considered an effective tool for monitoring patients taking AVKs.

Keywords:

anticoagulant therapy office

vitamin K antagonists

dosing

specialized software module

cardiovascular diseases associated mortality

INR

Authors:

Safin D.D.

Interregional clinical diagnostic center

Galimzyanov A.F.

Interregional clinical diagnostic center

Slyuter M.

OOO Portavita Health

Received:

10.02.2021

Accepted:

05.07.2021

List of references:

Russian Statistical Yearbook 2018, p. 694 (In Russ.)
Ralston J, Reddy KS, Fuster V, Narula J. Cardiovascular diseases on the global agenda: the United Nations high level meeting, Sustainable Development Goals, and the way forward. Glob Heart. 2016;11:375-379. https://doi.org/10.1016/j.gheart.2016.10.029
Bokeriya LA, Milievskaya EB, Kudzoeva ZF, Pryanishnikov VV. Bolezni i vrozhdennye anomalii sistemy krovoobrashcheniya, Serdechno-sosudistaya hirurgiya. M.: NMICSSKH im. A.N. Bakuleva MZ RF; 2017. (In Russ.).
Hart RG, Pearce LA, Aguilar MI. Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation. Annals of Internal Medicine. 2007;146:857-867. https://doi.org/10.7326/0003-4819-146-12-200706190-00007
Druilhe L, Humbert X. INR and vitamin K antagonists management by the primary care physicians in Normandy. Ann Biol Clin (Paris). 2020;78(2):157-173. https://doi.org/10.1684/abc.2020.1543
Bussey HI, Bussey M, Bussey-Smith KL, Frei CR. Evaluation of warfarin management with international normalized ratio self-testing and online remote monitoring and management plus low-dose vitamin k with genomic considerations: a pilot study. Pharmacotherapy. 2013;33(11):1136-1146. https://doi.org/10.1002/phar.1343
Cambus JP, Magnin D, Ambid-Lacombe C, Bura A, Desgrippes F, Schneller JM, Benhamou Y, Flaujac C, Horellou MH, De Raucourt E, Kaczan D, Astoul JM, Siguret V. Anticoagulant clinics are they effective in France? Performance evaluation of six anticoagulant clinics concerning the management of vitamin K antagonists. Rev Med Interne. 2013;34(9):515-521. https://doi.org/10.1016/j.revmed.2013.02.001
Bernstein MR, John L, Sciortino S, Arambages E, Auletta D, Spyropoulos AC. Does telehealth improve anticoagulation management in patient service centers (PSC)? A pilot project. J Thromb Thrombolysis. 2020;49(2):316-320. https://doi.org/10.1007/s11239-019-02031-4
Chu G, Seelig J, Trinks-Roerdink EM, Geersing GJ, Rutten FH, de Groot JR, Huisman MV, Hemels MEW. Antithrombotic management of patients with atrial fibrillation — Dutch anticoagulant initiatives anno 2020. Neth Heart J. 2020;28(suppl 1):19-24. https://doi.org/10.1007/s12471-020-01446-6
Zielinski GD, van Rein N, Teichert M, Klok FA, Rosendaal FR, van der Meer FJM, Huisman MV, Cannegieter SC, Lijfering WM. Persistence of oral anticoagulant treatment for atrial fibrillation in the Netherlands: A surveillance study. Res Pract Thromb Haemost. 2019;4(1):141-153.
Barnes GD, Kline-Rogers E, Graves C, Puroll E, Gu X, Townsend K, McMahon E, Craig T, Froehlich JB. Structure and function of anticoagulation clinics in the United States: an AC forum membership survey. J Thromb Thrombolysis. 2018;46(1):7-11. https://doi.org/10.1007/s11239-018-1652-z
Hruslov MV. Sovremennyj podhod k organizacii monitoringa pacientov, prinimayushchih nepryamye antikoagulyanty. Bulletin of Medical Internet Conferences. 2016;6:1460-1461. (In Russ.).
Vorob’eva NA, Vorob’eva AI, Shchapkov AA, Karpunov AA. Kliniko-ekonomicheskoe obosnovanie sozdaniya sistemy centralizovannogo laboratornogo monitoringa bezopasnosti i effektivnosti antikoagulyantnoj terapii v Arhangel’skoj oblasti. Laboratornaya sluzhba. 2018;7(2):56-62. (In Russ.).
Ignatenko GA, Ignatenko TS, Denisova EM, Evtushenko IS, Sergienko NV. Nuzhen li centralizovannyj kontrol’ antikoagulyantnoj terapii v Donbasse? Universitetskaya klinika. 2019;2(31):61-65. (In Russ.).
Vavilova TV, Solov’eva LV, Bekoeva AB, Zubkova PYu, Vorob’eva NA, Vorob’eva AI, Mel’nichuk EYu, Hruslov MV, Vereina NK, Safin DD, Galyavich AS, Sluiter M, Endubaeva GV, Shlyahto EV. Luchshie praktiki Rossijskoj Federacii v organizacii antikoagulyantnoj terapii u bol’nyh vysokogo riska tromboembolicheskih oslozhnenij. Rossijskij kardiologicheskij zhurnal. 2020;25(6):10-14. (In Russ.).
Vorob’eva NA, Vorob’eva AI, Shemyakina NYa, Alekseeva AS. Pacient-orientirovannyj podhod kak osnova povysheniya effektivnosti i bezopasnosti antitromboticheskoj terapii u komorbidnyh pacientov. Rol’ antikoagulyantnyh kabinetov. Klinicheskaya gerontologiya. 2019;25(11-12):19-24. (In Russ.).

Close metadata