Pharmacist-managed international normalized ratio patient self-testing is associated with increased time in therapeutic range in patients with left ventricular assist devices at an academic medical center.
Identifieur interne : 001307 ( Ncbi/Curation ); précédent : 001306; suivant : 001308Pharmacist-managed international normalized ratio patient self-testing is associated with increased time in therapeutic range in patients with left ventricular assist devices at an academic medical center.
Auteurs : Martin A. Bishop [États-Unis] ; Michael B. Streiff ; Christopher R. Ensor ; Ryan J. Tedford ; Stuart D. Russell ; Patricia A. RossSource :
- ASAIO journal (American Society for Artificial Internal Organs : 1992) [ 1538-943X ]
Descripteurs français
- KwdFr :
- Adulte d'âge moyen, Anticoagulants (sang), Anticoagulants (usage thérapeutique), Autosoins (), Centres hospitaliers universitaires, Dispositifs d'assistance circulatoire, Femelle, Humains, Mâle, Pharmaciens, Surveillance pharmacologique (), Systèmes automatisés lit malade, Taux normalisé international, Warfarine (sang), Warfarine (usage thérapeutique), Études de cohortes, Études rétrospectives.
- MESH :
- sang : Anticoagulants, Warfarine.
- usage thérapeutique : Anticoagulants, Warfarine.
- Adulte d'âge moyen, Autosoins, Centres hospitaliers universitaires, Dispositifs d'assistance circulatoire, Femelle, Humains, Mâle, Pharmaciens, Surveillance pharmacologique, Systèmes automatisés lit malade, Taux normalisé international, Études de cohortes, Études rétrospectives.
English descriptors
- KwdEn :
- Academic Medical Centers, Anticoagulants (blood), Anticoagulants (therapeutic use), Cohort Studies, Drug Monitoring (methods), Female, Heart-Assist Devices, Humans, International Normalized Ratio, Male, Middle Aged, Pharmacists, Point-of-Care Systems, Retrospective Studies, Self Care (methods), Warfarin (blood), Warfarin (therapeutic use).
- MESH :
- chemical , blood : Anticoagulants, Warfarin.
- chemical , therapeutic use : Anticoagulants, Warfarin.
- methods : Drug Monitoring, Self Care.
- Academic Medical Centers, Cohort Studies, Female, Heart-Assist Devices, Humans, International Normalized Ratio, Male, Middle Aged, Pharmacists, Point-of-Care Systems, Retrospective Studies.
Abstract
Patients with left ventricular assist devices (LVADs) are at increased risk of bleeding and thrombotic complications making warfarin therapy particularly challenging. Patient self-testing (PST) using point-of-care international normalized ratio (INR) devices has shown favorable outcomes in other populations, but the use of PST in LVAD patients has not been well described. The purpose of this study was to evaluate the effectiveness of pharmacist-managed INR PST versus usual care (UC) in patients with LVADs at a single center. We performed a retrospective cohort study of adult patients (in a 1:4 ratio PST versus UC) implanted with an LVAD (HeartMate II or HVAD) treated with warfarin from January 1, 2007, to January 31, 2013. We reviewed all INRs and bleeding/thrombotic events in LVAD patients whose anticoagulation was managed by clinical pharmacists via INR PST versus UC and calculated a percent time in therapeutic range (%TTR) by Rosendaal method. Fifty-five patients were studied. Demographic data were generally similar between the cohorts. Mean %TTR was higher in the PST cohort versus UC (44.4% vs. 30.6%, p = 0.026). There was no difference in the rate per patient-year of bleeding (0.23 vs. 0.33, p = 0.55) or thrombotic events (0.12 vs. 0.13, p = 0.88). Pharmacist-managed INR PST is associated with an increased %TTR in patients with LVADs.
DOI: 10.1097/MAT.0000000000000047
PubMed: 24577370
Links toward previous steps (curation, corpus...)
- to stream PubMed, to step Corpus: Pour aller vers cette notice dans l'étape Curation :003852
- to stream PubMed, to step Curation: Pour aller vers cette notice dans l'étape Curation :003826
- to stream PubMed, to step Checkpoint: Pour aller vers cette notice dans l'étape Curation :003826
- to stream Ncbi, to step Merge: Pour aller vers cette notice dans l'étape Curation :001307
Links to Exploration step
pubmed:24577370Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Pharmacist-managed international normalized ratio patient self-testing is associated with increased time in therapeutic range in patients with left ventricular assist devices at an academic medical center.</title><author><name sortKey="Bishop, Martin A" sort="Bishop, Martin A" uniqKey="Bishop M" first="Martin A" last="Bishop">Martin A. Bishop</name><affiliation wicri:level="2"><nlm:affiliation>From the *Department of Pharmacy, The Johns Hopkins Hospital, Baltimore, Maryland; †Division of Hematology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland; ‡Department of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy, Pittsburgh, Pennsylvania; §Division of Cardiology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Maryland</region></placeName><wicri:cityArea>From the *Department of Pharmacy, The Johns Hopkins Hospital, Baltimore, Maryland; †Division of Hematology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland; ‡Department of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy, Pittsburgh, Pennsylvania; §Division of Cardiology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore</wicri:cityArea></affiliation></author><author><name sortKey="Streiff, Michael B" sort="Streiff, Michael B" uniqKey="Streiff M" first="Michael B" last="Streiff">Michael B. Streiff</name></author><author><name sortKey="Ensor, Christopher R" sort="Ensor, Christopher R" uniqKey="Ensor C" first="Christopher R" last="Ensor">Christopher R. Ensor</name></author><author><name sortKey="Tedford, Ryan J" sort="Tedford, Ryan J" uniqKey="Tedford R" first="Ryan J" last="Tedford">Ryan J. Tedford</name></author><author><name sortKey="Russell, Stuart D" sort="Russell, Stuart D" uniqKey="Russell S" first="Stuart D" last="Russell">Stuart D. Russell</name></author><author><name sortKey="Ross, Patricia A" sort="Ross, Patricia A" uniqKey="Ross P" first="Patricia A" last="Ross">Patricia A. Ross</name></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="????"><PubDate><MedlineDate>2014 Mar-Apr</MedlineDate></PubDate></date><idno type="RBID">pubmed:24577370</idno><idno type="pmid">24577370</idno><idno type="doi">10.1097/MAT.0000000000000047</idno><idno type="wicri:Area/PubMed/Corpus">003852</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Corpus" wicri:corpus="PubMed">003852</idno><idno type="wicri:Area/PubMed/Curation">003826</idno><idno type="wicri:explorRef" wicri:stream="PubMed" wicri:step="Curation">003826</idno><idno type="wicri:Area/PubMed/Checkpoint">003826</idno><idno type="wicri:explorRef" wicri:stream="Checkpoint" wicri:step="PubMed">003826</idno><idno type="wicri:Area/Ncbi/Merge">001307</idno><idno type="wicri:Area/Ncbi/Curation">001307</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Pharmacist-managed international normalized ratio patient self-testing is associated with increased time in therapeutic range in patients with left ventricular assist devices at an academic medical center.</title><author><name sortKey="Bishop, Martin A" sort="Bishop, Martin A" uniqKey="Bishop M" first="Martin A" last="Bishop">Martin A. Bishop</name><affiliation wicri:level="2"><nlm:affiliation>From the *Department of Pharmacy, The Johns Hopkins Hospital, Baltimore, Maryland; †Division of Hematology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland; ‡Department of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy, Pittsburgh, Pennsylvania; §Division of Cardiology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland.</nlm:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Maryland</region></placeName><wicri:cityArea>From the *Department of Pharmacy, The Johns Hopkins Hospital, Baltimore, Maryland; †Division of Hematology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore, Maryland; ‡Department of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy, Pittsburgh, Pennsylvania; §Division of Cardiology, Department of Medicine, The Johns Hopkins University School of Medicine, Baltimore</wicri:cityArea></affiliation></author><author><name sortKey="Streiff, Michael B" sort="Streiff, Michael B" uniqKey="Streiff M" first="Michael B" last="Streiff">Michael B. Streiff</name></author><author><name sortKey="Ensor, Christopher R" sort="Ensor, Christopher R" uniqKey="Ensor C" first="Christopher R" last="Ensor">Christopher R. Ensor</name></author><author><name sortKey="Tedford, Ryan J" sort="Tedford, Ryan J" uniqKey="Tedford R" first="Ryan J" last="Tedford">Ryan J. Tedford</name></author><author><name sortKey="Russell, Stuart D" sort="Russell, Stuart D" uniqKey="Russell S" first="Stuart D" last="Russell">Stuart D. Russell</name></author><author><name sortKey="Ross, Patricia A" sort="Ross, Patricia A" uniqKey="Ross P" first="Patricia A" last="Ross">Patricia A. Ross</name></author></analytic><series><title level="j">ASAIO journal (American Society for Artificial Internal Organs : 1992)</title><idno type="eISSN">1538-943X</idno></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Academic Medical Centers</term><term>Anticoagulants (blood)</term><term>Anticoagulants (therapeutic use)</term><term>Cohort Studies</term><term>Drug Monitoring (methods)</term><term>Female</term><term>Heart-Assist Devices</term><term>Humans</term><term>International Normalized Ratio</term><term>Male</term><term>Middle Aged</term><term>Pharmacists</term><term>Point-of-Care Systems</term><term>Retrospective Studies</term><term>Self Care (methods)</term><term>Warfarin (blood)</term><term>Warfarin (therapeutic use)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Anticoagulants (sang)</term><term>Anticoagulants (usage thérapeutique)</term><term>Autosoins ()</term><term>Centres hospitaliers universitaires</term><term>Dispositifs d'assistance circulatoire</term><term>Femelle</term><term>Humains</term><term>Mâle</term><term>Pharmaciens</term><term>Surveillance pharmacologique ()</term><term>Systèmes automatisés lit malade</term><term>Taux normalisé international</term><term>Warfarine (sang)</term><term>Warfarine (usage thérapeutique)</term><term>Études de cohortes</term><term>Études rétrospectives</term></keywords><keywords scheme="MESH" type="chemical" qualifier="blood" xml:lang="en"><term>Anticoagulants</term><term>Warfarin</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Anticoagulants</term><term>Warfarin</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Drug Monitoring</term><term>Self Care</term></keywords><keywords scheme="MESH" qualifier="sang" xml:lang="fr"><term>Anticoagulants</term><term>Warfarine</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Anticoagulants</term><term>Warfarine</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Academic Medical Centers</term><term>Cohort Studies</term><term>Female</term><term>Heart-Assist Devices</term><term>Humans</term><term>International Normalized Ratio</term><term>Male</term><term>Middle Aged</term><term>Pharmacists</term><term>Point-of-Care Systems</term><term>Retrospective Studies</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Adulte d'âge moyen</term><term>Autosoins</term><term>Centres hospitaliers universitaires</term><term>Dispositifs d'assistance circulatoire</term><term>Femelle</term><term>Humains</term><term>Mâle</term><term>Pharmaciens</term><term>Surveillance pharmacologique</term><term>Systèmes automatisés lit malade</term><term>Taux normalisé international</term><term>Études de cohortes</term><term>Études rétrospectives</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Patients with left ventricular assist devices (LVADs) are at increased risk of bleeding and thrombotic complications making warfarin therapy particularly challenging. Patient self-testing (PST) using point-of-care international normalized ratio (INR) devices has shown favorable outcomes in other populations, but the use of PST in LVAD patients has not been well described. The purpose of this study was to evaluate the effectiveness of pharmacist-managed INR PST versus usual care (UC) in patients with LVADs at a single center. We performed a retrospective cohort study of adult patients (in a 1:4 ratio PST versus UC) implanted with an LVAD (HeartMate II or HVAD) treated with warfarin from January 1, 2007, to January 31, 2013. We reviewed all INRs and bleeding/thrombotic events in LVAD patients whose anticoagulation was managed by clinical pharmacists via INR PST versus UC and calculated a percent time in therapeutic range (%TTR) by Rosendaal method. Fifty-five patients were studied. Demographic data were generally similar between the cohorts. Mean %TTR was higher in the PST cohort versus UC (44.4% vs. 30.6%, p = 0.026). There was no difference in the rate per patient-year of bleeding (0.23 vs. 0.33, p = 0.55) or thrombotic events (0.12 vs. 0.13, p = 0.88). Pharmacist-managed INR PST is associated with an increased %TTR in patients with LVADs.</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
EXPLOR_STEP=$WICRI_ROOT/Wicri/Amérique/explor/PittsburghV1/Data/Ncbi/Curation
HfdSelect -h $EXPLOR_STEP/biblio.hfd -nk 001307 | SxmlIndent | more
Ou
HfdSelect -h $EXPLOR_AREA/Data/Ncbi/Curation/biblio.hfd -nk 001307 | SxmlIndent | more
Pour mettre un lien sur cette page dans le réseau Wicri
{{Explor lien
|wiki= Wicri/Amérique
|area= PittsburghV1
|flux= Ncbi
|étape= Curation
|type= RBID
|clé= pubmed:24577370
|texte= Pharmacist-managed international normalized ratio patient self-testing is associated with increased time in therapeutic range in patients with left ventricular assist devices at an academic medical center.
}}
Pour générer des pages wiki
HfdIndexSelect -h $EXPLOR_AREA/Data/Ncbi/Curation/RBID.i -Sk "pubmed:24577370" \
| HfdSelect -Kh $EXPLOR_AREA/Data/Ncbi/Curation/biblio.hfd \
| NlmPubMed2Wicri -a PittsburghV1
| This area was generated with Dilib version V0.6.38. |  |