Impact of age on long‐term anticoagulation and how gender and monitoring setting affect it: implications for decision making and patient management
Aims Stabilization of anticoagulation control is seminal to reducing the risk of adverse effects of vitamin K antagonists. Reliable information on how ageing influences this is lacking. We set out to assess the true age‐related changes in anticoagulation control, how gender and patient setting influ...
Gespeichert in:
| Veröffentlicht in: | British journal of clinical pharmacology 2016-10, Vol.82 (4), p.1076-1083 |
|---|---|
| Hauptverfasser: | , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 1083 |
|---|---|
| container_issue | 4 |
| container_start_page | 1076 |
| container_title | British journal of clinical pharmacology |
| container_volume | 82 |
| creator | Abohelaika, Salah Wynne, Hilary Avery, Peter Robinson, Brian Kesteven, Patrick Kamali, Farhad |
| description | Aims
Stabilization of anticoagulation control is seminal to reducing the risk of adverse effects of vitamin K antagonists. Reliable information on how ageing influences this is lacking. We set out to assess the true age‐related changes in anticoagulation control, how gender and patient setting influence this, and the possible implications of these for patient outcomes and management.
Methods
In atrial fibrillation (AF) patients of a unified anticoagulant service monitoring patients in general practice or hospital‐based clinics and housebound patients at home, international normalized ratio (INR) and warfarin dose data between 2000 and 2013 were extracted via the DAWN dosing program. Anticoagulation control was assessed by calculating percentage time spent within target INR (TTR).
Results
A total of 2094 AF patients [938 (44.8%) in general practice (GP) and 531 (25.4%) in hospital (H)‐based clinics and 625 (29.8%) through the domiciliary service (D)] were evaluated. The frequency of warfarin dose changes and INR monitoring events declined until about age 67, then increased as patients got older. The TTR according to age was significantly lower and the probability of having a TTR ≤65% according to age was higher for D than for H and GP, and females had a greater probability of having a TTR ≤65% than age‐matched males.
Conclusion
Identification of factors underlying poorer anticoagulation control in older housebound patients and the introduction of effective modifications to improve the clinical effectiveness of anticoagulation in such patients is needed. |
| doi_str_mv | 10.1111/bcp.13046 |
| format | Article |
| fullrecord | <record><control><sourceid>wiley_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5137833</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>BCP13046</sourcerecordid><originalsourceid>FETCH-LOGICAL-c4156-5cf76dc223267bc4962c8f5f034072440d29ed27e85fc4b6fb6ec10ee3be567d3</originalsourceid><addsrcrecordid>eNp1kc1uEzEUhS1E1YS0C14AecsijX_GnpQFEkT8RIpUFnRteTzXE8OMPfK4jbLjEdjwgjwJzgytYFFvru1z7ndtHYReUnJF81pVpr-inBTyGZpTLsWSUSaeoznhRC4FE3SGXgzDN0Iop1KcoxkrOS0kl3P0a9v12iQcLNYN4OBxG3zz-8fPBLHD2idngm7uWp1c1rSv8T4ccAO-hjgeu-BdCtH5Bg-Q0qlqayEjXXqDXde3zozNA7Yh4hqMG06oTn8fvRnRZx18ylc-v6HL2wt0ZnU7wOXfukC3Hz983Xxe7m4-bTfvdktTUJG_Zmwpa8MYZ7KsTHEtmVlbYQkvSMmKgtTsGmpWwlpYU1TSVhIMJQC8AiHLmi_Q24nb31Ud1CaPjrpVfXSdjkcVtFP_K97tVRPulaC8XHOeAa8ngIlhGCLYx15K1CkblbNRYzbZ--rfYY_OhzCyYTUZDq6F49Mk9X7zZUL-AVeEnkY</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>Impact of age on long‐term anticoagulation and how gender and monitoring setting affect it: implications for decision making and patient management</title><source>Wiley Free Content</source><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><creator>Abohelaika, Salah ; Wynne, Hilary ; Avery, Peter ; Robinson, Brian ; Kesteven, Patrick ; Kamali, Farhad</creator><creatorcontrib>Abohelaika, Salah ; Wynne, Hilary ; Avery, Peter ; Robinson, Brian ; Kesteven, Patrick ; Kamali, Farhad</creatorcontrib><description>Aims
Stabilization of anticoagulation control is seminal to reducing the risk of adverse effects of vitamin K antagonists. Reliable information on how ageing influences this is lacking. We set out to assess the true age‐related changes in anticoagulation control, how gender and patient setting influence this, and the possible implications of these for patient outcomes and management.
Methods
In atrial fibrillation (AF) patients of a unified anticoagulant service monitoring patients in general practice or hospital‐based clinics and housebound patients at home, international normalized ratio (INR) and warfarin dose data between 2000 and 2013 were extracted via the DAWN dosing program. Anticoagulation control was assessed by calculating percentage time spent within target INR (TTR).
Results
A total of 2094 AF patients [938 (44.8%) in general practice (GP) and 531 (25.4%) in hospital (H)‐based clinics and 625 (29.8%) through the domiciliary service (D)] were evaluated. The frequency of warfarin dose changes and INR monitoring events declined until about age 67, then increased as patients got older. The TTR according to age was significantly lower and the probability of having a TTR ≤65% according to age was higher for D than for H and GP, and females had a greater probability of having a TTR ≤65% than age‐matched males.
Conclusion
Identification of factors underlying poorer anticoagulation control in older housebound patients and the introduction of effective modifications to improve the clinical effectiveness of anticoagulation in such patients is needed.</description><identifier>ISSN: 0306-5251</identifier><identifier>EISSN: 1365-2125</identifier><identifier>DOI: 10.1111/bcp.13046</identifier><identifier>PMID: 27314636</identifier><language>eng</language><publisher>England: John Wiley and Sons Inc</publisher><subject>Adult ; Age Factors ; Aged ; ageing ; Anticoagulants - adverse effects ; anticoagulation ; atrial fibrillation ; Clinical Decision-Making ; Drug Monitoring ; Drug Safety ; Female ; General Practice - statistics & numerical data ; Home Care Services - statistics & numerical data ; Hospitalization - statistics & numerical data ; Humans ; International Normalized Ratio ; Male ; Middle Aged ; Sex Factors ; stroke ; Time Factors ; Treatment Outcome ; TTR ; warfarin</subject><ispartof>British journal of clinical pharmacology, 2016-10, Vol.82 (4), p.1076-1083</ispartof><rights>2016 The British Pharmacological Society</rights><rights>2016 The British Pharmacological Society.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4156-5cf76dc223267bc4962c8f5f034072440d29ed27e85fc4b6fb6ec10ee3be567d3</citedby><cites>FETCH-LOGICAL-c4156-5cf76dc223267bc4962c8f5f034072440d29ed27e85fc4b6fb6ec10ee3be567d3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fbcp.13046$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fbcp.13046$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>230,314,776,780,881,1411,1427,27901,27902,45550,45551,46384,46808</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27314636$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Abohelaika, Salah</creatorcontrib><creatorcontrib>Wynne, Hilary</creatorcontrib><creatorcontrib>Avery, Peter</creatorcontrib><creatorcontrib>Robinson, Brian</creatorcontrib><creatorcontrib>Kesteven, Patrick</creatorcontrib><creatorcontrib>Kamali, Farhad</creatorcontrib><title>Impact of age on long‐term anticoagulation and how gender and monitoring setting affect it: implications for decision making and patient management</title><title>British journal of clinical pharmacology</title><addtitle>Br J Clin Pharmacol</addtitle><description>Aims
Stabilization of anticoagulation control is seminal to reducing the risk of adverse effects of vitamin K antagonists. Reliable information on how ageing influences this is lacking. We set out to assess the true age‐related changes in anticoagulation control, how gender and patient setting influence this, and the possible implications of these for patient outcomes and management.
Methods
In atrial fibrillation (AF) patients of a unified anticoagulant service monitoring patients in general practice or hospital‐based clinics and housebound patients at home, international normalized ratio (INR) and warfarin dose data between 2000 and 2013 were extracted via the DAWN dosing program. Anticoagulation control was assessed by calculating percentage time spent within target INR (TTR).
Results
A total of 2094 AF patients [938 (44.8%) in general practice (GP) and 531 (25.4%) in hospital (H)‐based clinics and 625 (29.8%) through the domiciliary service (D)] were evaluated. The frequency of warfarin dose changes and INR monitoring events declined until about age 67, then increased as patients got older. The TTR according to age was significantly lower and the probability of having a TTR ≤65% according to age was higher for D than for H and GP, and females had a greater probability of having a TTR ≤65% than age‐matched males.
Conclusion
Identification of factors underlying poorer anticoagulation control in older housebound patients and the introduction of effective modifications to improve the clinical effectiveness of anticoagulation in such patients is needed.</description><subject>Adult</subject><subject>Age Factors</subject><subject>Aged</subject><subject>ageing</subject><subject>Anticoagulants - adverse effects</subject><subject>anticoagulation</subject><subject>atrial fibrillation</subject><subject>Clinical Decision-Making</subject><subject>Drug Monitoring</subject><subject>Drug Safety</subject><subject>Female</subject><subject>General Practice - statistics & numerical data</subject><subject>Home Care Services - statistics & numerical data</subject><subject>Hospitalization - statistics & numerical data</subject><subject>Humans</subject><subject>International Normalized Ratio</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Sex Factors</subject><subject>stroke</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>TTR</subject><subject>warfarin</subject><issn>0306-5251</issn><issn>1365-2125</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kc1uEzEUhS1E1YS0C14AecsijX_GnpQFEkT8RIpUFnRteTzXE8OMPfK4jbLjEdjwgjwJzgytYFFvru1z7ndtHYReUnJF81pVpr-inBTyGZpTLsWSUSaeoznhRC4FE3SGXgzDN0Iop1KcoxkrOS0kl3P0a9v12iQcLNYN4OBxG3zz-8fPBLHD2idngm7uWp1c1rSv8T4ccAO-hjgeu-BdCtH5Bg-Q0qlqayEjXXqDXde3zozNA7Yh4hqMG06oTn8fvRnRZx18ylc-v6HL2wt0ZnU7wOXfukC3Hz983Xxe7m4-bTfvdktTUJG_Zmwpa8MYZ7KsTHEtmVlbYQkvSMmKgtTsGmpWwlpYU1TSVhIMJQC8AiHLmi_Q24nb31Ud1CaPjrpVfXSdjkcVtFP_K97tVRPulaC8XHOeAa8ngIlhGCLYx15K1CkblbNRYzbZ--rfYY_OhzCyYTUZDq6F49Mk9X7zZUL-AVeEnkY</recordid><startdate>201610</startdate><enddate>201610</enddate><creator>Abohelaika, Salah</creator><creator>Wynne, Hilary</creator><creator>Avery, Peter</creator><creator>Robinson, Brian</creator><creator>Kesteven, Patrick</creator><creator>Kamali, Farhad</creator><general>John Wiley and Sons Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>5PM</scope></search><sort><creationdate>201610</creationdate><title>Impact of age on long‐term anticoagulation and how gender and monitoring setting affect it: implications for decision making and patient management</title><author>Abohelaika, Salah ; Wynne, Hilary ; Avery, Peter ; Robinson, Brian ; Kesteven, Patrick ; Kamali, Farhad</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4156-5cf76dc223267bc4962c8f5f034072440d29ed27e85fc4b6fb6ec10ee3be567d3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Age Factors</topic><topic>Aged</topic><topic>ageing</topic><topic>Anticoagulants - adverse effects</topic><topic>anticoagulation</topic><topic>atrial fibrillation</topic><topic>Clinical Decision-Making</topic><topic>Drug Monitoring</topic><topic>Drug Safety</topic><topic>Female</topic><topic>General Practice - statistics & numerical data</topic><topic>Home Care Services - statistics & numerical data</topic><topic>Hospitalization - statistics & numerical data</topic><topic>Humans</topic><topic>International Normalized Ratio</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Sex Factors</topic><topic>stroke</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>TTR</topic><topic>warfarin</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Abohelaika, Salah</creatorcontrib><creatorcontrib>Wynne, Hilary</creatorcontrib><creatorcontrib>Avery, Peter</creatorcontrib><creatorcontrib>Robinson, Brian</creatorcontrib><creatorcontrib>Kesteven, Patrick</creatorcontrib><creatorcontrib>Kamali, Farhad</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>British journal of clinical pharmacology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Abohelaika, Salah</au><au>Wynne, Hilary</au><au>Avery, Peter</au><au>Robinson, Brian</au><au>Kesteven, Patrick</au><au>Kamali, Farhad</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of age on long‐term anticoagulation and how gender and monitoring setting affect it: implications for decision making and patient management</atitle><jtitle>British journal of clinical pharmacology</jtitle><addtitle>Br J Clin Pharmacol</addtitle><date>2016-10</date><risdate>2016</risdate><volume>82</volume><issue>4</issue><spage>1076</spage><epage>1083</epage><pages>1076-1083</pages><issn>0306-5251</issn><eissn>1365-2125</eissn><abstract>Aims
Stabilization of anticoagulation control is seminal to reducing the risk of adverse effects of vitamin K antagonists. Reliable information on how ageing influences this is lacking. We set out to assess the true age‐related changes in anticoagulation control, how gender and patient setting influence this, and the possible implications of these for patient outcomes and management.
Methods
In atrial fibrillation (AF) patients of a unified anticoagulant service monitoring patients in general practice or hospital‐based clinics and housebound patients at home, international normalized ratio (INR) and warfarin dose data between 2000 and 2013 were extracted via the DAWN dosing program. Anticoagulation control was assessed by calculating percentage time spent within target INR (TTR).
Results
A total of 2094 AF patients [938 (44.8%) in general practice (GP) and 531 (25.4%) in hospital (H)‐based clinics and 625 (29.8%) through the domiciliary service (D)] were evaluated. The frequency of warfarin dose changes and INR monitoring events declined until about age 67, then increased as patients got older. The TTR according to age was significantly lower and the probability of having a TTR ≤65% according to age was higher for D than for H and GP, and females had a greater probability of having a TTR ≤65% than age‐matched males.
Conclusion
Identification of factors underlying poorer anticoagulation control in older housebound patients and the introduction of effective modifications to improve the clinical effectiveness of anticoagulation in such patients is needed.</abstract><cop>England</cop><pub>John Wiley and Sons Inc</pub><pmid>27314636</pmid><doi>10.1111/bcp.13046</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0306-5251 |
| ispartof | British journal of clinical pharmacology, 2016-10, Vol.82 (4), p.1076-1083 |
| issn | 0306-5251 1365-2125 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_5137833 |
| source | Wiley Free Content; MEDLINE; Wiley Online Library Journals Frontfile Complete; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Adult Age Factors Aged ageing Anticoagulants - adverse effects anticoagulation atrial fibrillation Clinical Decision-Making Drug Monitoring Drug Safety Female General Practice - statistics & numerical data Home Care Services - statistics & numerical data Hospitalization - statistics & numerical data Humans International Normalized Ratio Male Middle Aged Sex Factors stroke Time Factors Treatment Outcome TTR warfarin |
| title | Impact of age on long‐term anticoagulation and how gender and monitoring setting affect it: implications for decision making and patient management |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-28T11%3A39%3A48IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-wiley_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Impact%20of%20age%20on%20long%E2%80%90term%20anticoagulation%20and%20how%20gender%20and%20monitoring%20setting%20affect%20it:%20implications%20for%20decision%20making%20and%20patient%20management&rft.jtitle=British%20journal%20of%20clinical%20pharmacology&rft.au=Abohelaika,%20Salah&rft.date=2016-10&rft.volume=82&rft.issue=4&rft.spage=1076&rft.epage=1083&rft.pages=1076-1083&rft.issn=0306-5251&rft.eissn=1365-2125&rft_id=info:doi/10.1111/bcp.13046&rft_dat=%3Cwiley_pubme%3EBCP13046%3C/wiley_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_id=info:pmid/27314636&rfr_iscdi=true |