Anticoagulation Management Practice, and Associated Factors in Atrial Fibrillation Patients on Warfarin Therapy at Saint Paul Hospital Millennium Medical College

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Addis Abeba University


Anticoagulants are cornerstones in management of Atrial Fibrillation to prevent stroke. Monitoring of warfarin depends on time in therapeutic range, frequency of international normalization range measurements, warfarin dose adjustments, warfarin drug interaction and bleeding adverse event. This study aimed to assess the anticoagulation management, and factors affecting anticoagulation management in atrial fibrillation patients taking warfarin. Institutionalbased Retrospective Cross-Sectional study was conducted from August to October 2019 at St. Paul Hospital Millennium Medical College. Data were collected retrospectively from a total of 300 patient medical records. Patients who have taken warfarin as an indication of primary prevention of atrial fibrillation were included in the study. A systematic random sampling technique was employed while recruiting the study participants. The data were entered to Statistical Package for Social Science window version 25 for analysis. Descriptive summaries were presented by using frequencies and percentages. Time in therapeutic range was calculated using the Rosendaal method, international normalization range frequency and drug interaction with warfarin were assessed and warfarin dose adjustments were also checked. Univariate and multivariate analysis were used to determine factors affecting time in therapeutic range and bleeding events. P-value ≤0.05 was considered as statistically significant. The mean age of the patient was 56.37 years and 65.3% of the study participants were females. Percent time in therapeutic range was found to be 42.03 ± 18.75. Only 12.67% patients had a time in the therapeutic range above 65%. Out of the 3162 INR tests, only 1094(34.60%) tests were within the therapeutic range. Bleeding event was recorded on 62 (20.70%) of the patients. Poor time in therapeutic range was associated with only age between 65 and 74, number of comedication of 1 and 2 and presence of congestive heart failure. Anticoagulation management was found to be poor in this study compared to other studies.



Warfarin, Bleeding, Time in Therapeutic range, Stroke, Atrial Fibrillation