OUTPATIENT MANAGEMENT OF WARFARIN THERAPY - COMPARISON OF COMPUTER-PREDICTED DOSAGE ADJUSTMENT TO SKILLED PROFESSIONAL CARE

被引:35
作者
WHITE, RH [1 ]
MUNGALL, D [1 ]
机构
[1] FERRIS STATE UNIV,DEPT PHARM,BIG RAPIDS,MI
关键词
ANTICOAGULATION; WARFARIN; COMPUTER;
D O I
10.1097/00007691-199101000-00006
中图分类号
R446 [实验室诊断]; R-33 [实验医学、医学实验];
学科分类号
1001 ;
摘要
In a prospective, randomized clinical trial, we compared the accuracy of warfarin dosage-adjustments predictions using a computer program to the skill of an experienced anticoagulation nurse-specialist. The computer program predicts the steady state warfarin dose by applying Bayesian forecasting techniques to a mathematical model of the dynamic pharmacologic response to warfarin. Fifty patients who were receiving chronic warfarin therapy and who required a dosage adjustment because their prothrombin time was greater-than-or-equal-to 2 s away from their target prothrombin time were enrolled. The baseline characteristics of each group were similar, including the mean of the absolute value of the differences between initial prothrombin times and corresponding target prothrombin times. After a new warfarin dose was predicted, the prothrombin time was measured at least 7 days after dosage adjustment. Overall, the results in each group were comparable. There was no significant difference between groups and the mean of the absolute value of the differences between final prothrombin times and target prothrombin times, nor was there a difference in the proportion of patients who had a final prothrombin time within 2 s of the target prothrombin time. We conclude that the accuracy of warfarin dosage adjustments made using computer modeling is comparable to the skill of an anticoagulation nurse-specialist.
引用
收藏
页码:46 / 50
页数:5
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