ANTICOAGULATION CONTROL in Primary care

1. ANTICOAGULATION CONTROLin Primary care Wansford surgery Dr Amrit Takhar

2. Background • Increasing numbers of patients identified needing anticoagulation • Gradual move towards control in the community • Research evidence showing success of primary care monitoring • Availability of near patient testing

3. Target INRs • These have been determined for each patient using guidelines from the British Haematology Society

4. Target INRs - using guidelines from the British Haematology Society – now changed

5. Changed target ranges 2000 • INR target 2.5, range 2-3 Atrial fibrillation, Single thromboembolic events, DVT prohylaxis including high risk surgery • INR target 3.5, range 3-4 All recurrent thromboembolic events Valve replacements

6. INR control AUDIT • All patients attending for INR tests were identified by a computer searches in March 1996 , March 1998 and June 2000 • The last INR was compared with the stated target INR for that patient