A recent study highlighted the challenges we face managing ED patients on warfarin therapy. Some key observations about how we're doing:
Only 71% of patients on warfarin had an INR checked
NontherapeuticINRs were recorded for 49%; ED providers intervened to address these results in 21% of cases
71% of patients with a supratherapeuticINR received an intervention compared with 9% of patients with a subtherapeuticINR
30% of patients received or were prescribed potentially interacting medications
Recommendations for specific anticoagulation follow-up were documented for only 19% of all patients
Literature continues to show warfarin is the most dangerous medication for our patients. Meticulous monitoring and follow up will help us potentially avoid serious interactions and adverse events.
References
Meeker E, et al. ED management of patients on warfarin therapy. Ann Emerg Med 2011;58:192-99.
