Evaluation of warfarin management in primary health care centers in Qatar: A retrospective cross-sectional analysis of the national dataset

Curr Probl Cardiol. 2024 Apr;49(4):102427. doi: 10.1016/j.cpcardiol.2024.102427. Epub 2024 Jan 30.

Abstract

Background: Warfarin management is associated with severe complications, highlighting the critical need to evaluate the quality of its administration.

Objectives: To evaluate the quality of warfarin management for patients managed in primary healthcare centers by measuring the percentage of Time in Therapeutic Range (TTR) and the proportion of extreme out-of-range international normalized ratio (INR) values.

Methods: This is a cross-sectional study. Data was extracted from a national dataset retrieved from the largest primary healthcare provider in Qatar. TTR was calculated using the traditional method. Inferential and descriptive analyses were performed as appropriate.

Results: Four hundred ninety-four patients met the inclusion criteria. The mean (SD) TTR was 45.3 % (17.5). This was significantly lower than the recommended cutoff value (P<0.001). Extreme out-of-range INR accounted for 24.7 % of total INR readings.

Conclusions: The management of patients taking warfarin in Qatar is inadequate. More effective strategies are warranted to ensure safe and effective therapy.

Keywords: Anticoagulants; Primary health care; Time in therapeutic range; Warfarin.

Publication types

  • Review

MeSH terms

  • Anticoagulants / adverse effects
  • Atrial Fibrillation* / complications
  • Cross-Sectional Studies
  • Humans
  • Primary Health Care
  • Qatar / epidemiology
  • Retrospective Studies
  • Warfarin* / adverse effects

Substances

  • Warfarin
  • Anticoagulants