Patient Time Requirements for Anticoagulation Therapy with Warfarin
Identifieur interne : 002717 ( Pmc/Corpus ); précédent : 002716; suivant : 002718Patient Time Requirements for Anticoagulation Therapy with Warfarin
Auteurs : Daniel E. Jonas ; Betsy Bryant Shilliday ; W. Russell Laundon ; Michael PignoneSource :
- Medical decision making : an international journal of the Society for Medical Decision Making [ 0272-989X ] ; 2009.
Abstract
Most patients receiving warfarin are man- aged in outpatient office settings or anticoagulation clinics that require frequent visits for monitoring.
To measure the amount and value of time required of patients for chronic anticoagulation therapy with warfarin.
Prospective observation of a cohort of adult patients treated at a university-based anticoagulation program.
Participants completed a questionnaire and a prospective diary of the time required for 1 visit to the anticoagulation clinic, including travel, waiting, and the clinic visit. The authors reviewed subjects’ medical records to obtain additional information, including the frequency of visits to the anti- coagulation clinic. They used the human capital method to estimate the value of time.
Eighty-five subjects completed the study. The mean (median) total time per visit was 147 minutes (123). Subjects averaged 15 visits per year (14) and spent 39.0 hours (29.3) per year on their visits. Other anticoagulation-related activities, such as communication with providers, pharmacy trips, and extra time preparing food, added an average of 52.7 hours (19.0) per year. The mean annual value of patient time spent traveling, waiting, and attending anticoagulation visits was $707 (median $591). The mean annual value when also including other anticoagulation-related activities was $1799 (median $1132).
The time required of patients for anticoagulation visits was considerable, averaging approximately 2.5 hours per visit and almost 40 hours per year. Methods for reducing patient time requirements, such as home-based testing, could reduce costs for patients, employers, and companions.
Url:
DOI: 10.1177/0272989X09343960
PubMed: 19773584
PubMed Central: 4181607
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PMC:4181607Le document en format XML
<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Patient Time Requirements for Anticoagulation Therapy with Warfarin</title>
<author><name sortKey="Jonas, Daniel E" sort="Jonas, Daniel E" uniqKey="Jonas D" first="Daniel E." last="Jonas">Daniel E. Jonas</name>
<affiliation><nlm:aff id="A1">Department of Medicine, University of North Carolina, Chapel Hill, NC</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Shilliday, Betsy Bryant" sort="Shilliday, Betsy Bryant" uniqKey="Shilliday B" first="Betsy Bryant" last="Shilliday">Betsy Bryant Shilliday</name>
<affiliation><nlm:aff id="A1">Department of Medicine, University of North Carolina, Chapel Hill, NC</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A2">School of Pharmacy, University of North Carolina, Chapel Hill, NC</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Laundon, W Russell" sort="Laundon, W Russell" uniqKey="Laundon W" first="W. Russell" last="Laundon">W. Russell Laundon</name>
<affiliation><nlm:aff id="A2">School of Pharmacy, University of North Carolina, Chapel Hill, NC</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Pignone, Michael" sort="Pignone, Michael" uniqKey="Pignone M" first="Michael" last="Pignone">Michael Pignone</name>
<affiliation><nlm:aff id="A1">Department of Medicine, University of North Carolina, Chapel Hill, NC</nlm:aff>
</affiliation>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Patient Time Requirements for Anticoagulation Therapy with Warfarin</title>
<author><name sortKey="Jonas, Daniel E" sort="Jonas, Daniel E" uniqKey="Jonas D" first="Daniel E." last="Jonas">Daniel E. Jonas</name>
<affiliation><nlm:aff id="A1">Department of Medicine, University of North Carolina, Chapel Hill, NC</nlm:aff>
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<author><name sortKey="Shilliday, Betsy Bryant" sort="Shilliday, Betsy Bryant" uniqKey="Shilliday B" first="Betsy Bryant" last="Shilliday">Betsy Bryant Shilliday</name>
<affiliation><nlm:aff id="A1">Department of Medicine, University of North Carolina, Chapel Hill, NC</nlm:aff>
</affiliation>
<affiliation><nlm:aff id="A2">School of Pharmacy, University of North Carolina, Chapel Hill, NC</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Laundon, W Russell" sort="Laundon, W Russell" uniqKey="Laundon W" first="W. Russell" last="Laundon">W. Russell Laundon</name>
<affiliation><nlm:aff id="A2">School of Pharmacy, University of North Carolina, Chapel Hill, NC</nlm:aff>
</affiliation>
</author>
<author><name sortKey="Pignone, Michael" sort="Pignone, Michael" uniqKey="Pignone M" first="Michael" last="Pignone">Michael Pignone</name>
<affiliation><nlm:aff id="A1">Department of Medicine, University of North Carolina, Chapel Hill, NC</nlm:aff>
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<series><title level="j">Medical decision making : an international journal of the Society for Medical Decision Making</title>
<idno type="ISSN">0272-989X</idno>
<idno type="eISSN">1552-681X</idno>
<imprint><date when="2009">2009</date>
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<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title>
<p id="P1">Most patients receiving warfarin are man- aged in outpatient office settings or anticoagulation clinics that require frequent visits for monitoring.</p>
</sec>
<sec id="S2"><title>Objective</title>
<p id="P2">To measure the amount and value of time required of patients for chronic anticoagulation therapy with warfarin.</p>
</sec>
<sec id="S3"><title>Design/Participants</title>
<p id="P3">Prospective observation of a cohort of adult patients treated at a university-based anticoagulation program.</p>
</sec>
<sec id="S4"><title>Measurements</title>
<p id="P4">Participants completed a questionnaire and a prospective diary of the time required for 1 visit to the anticoagulation clinic, including travel, waiting, and the clinic visit. The authors reviewed subjects’ medical records to obtain additional information, including the frequency of visits to the anti- coagulation clinic. They used the human capital method to estimate the value of time.</p>
</sec>
<sec id="S5"><title>Results</title>
<p id="P5">Eighty-five subjects completed the study. The mean (median) total time per visit was 147 minutes (123). Subjects averaged 15 visits per year (14) and spent 39.0 hours (29.3) per year on their visits. Other anticoagulation-related activities, such as communication with providers, pharmacy trips, and extra time preparing food, added an average of 52.7 hours (19.0) per year. The mean annual value of patient time spent traveling, waiting, and attending anticoagulation visits was $707 (median $591). The mean annual value when also including other anticoagulation-related activities was $1799 (median $1132).</p>
</sec>
<sec id="S6"><title>Conclusions</title>
<p id="P6">The time required of patients for anticoagulation visits was considerable, averaging approximately 2.5 hours per visit and almost 40 hours per year. Methods for reducing patient time requirements, such as home-based testing, could reduce costs for patients, employers, and companions.</p>
</sec>
</div>
</front>
</TEI>
<pmc article-type="research-article"><pmc-comment>The publisher of this article does not allow downloading of the full text in XML form.</pmc-comment>
<pmc-dir>properties manuscript</pmc-dir>
<front><journal-meta><journal-id journal-id-type="nlm-journal-id">8109073</journal-id>
<journal-id journal-id-type="pubmed-jr-id">5668</journal-id>
<journal-id journal-id-type="nlm-ta">Med Decis Making</journal-id>
<journal-id journal-id-type="iso-abbrev">Med Decis Making</journal-id>
<journal-title-group><journal-title>Medical decision making : an international journal of the Society for Medical Decision Making</journal-title>
</journal-title-group>
<issn pub-type="ppub">0272-989X</issn>
<issn pub-type="epub">1552-681X</issn>
</journal-meta>
<article-meta><article-id pub-id-type="pmid">19773584</article-id>
<article-id pub-id-type="pmc">4181607</article-id>
<article-id pub-id-type="doi">10.1177/0272989X09343960</article-id>
<article-id pub-id-type="manuscript">NIHMS626932</article-id>
<article-categories><subj-group subj-group-type="heading"><subject>Article</subject>
</subj-group>
</article-categories>
<title-group><article-title>Patient Time Requirements for Anticoagulation Therapy with Warfarin</article-title>
</title-group>
<contrib-group><contrib contrib-type="author"><name><surname>Jonas</surname>
<given-names>Daniel E.</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="corresp" rid="CR1">*</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Shilliday</surname>
<given-names>Betsy Bryant</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Laundon</surname>
<given-names>W. Russell</given-names>
</name>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author"><name><surname>Pignone</surname>
<given-names>Michael</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
</contrib-group>
<aff id="A1"><label>1</label>
Department of Medicine, University of North Carolina, Chapel Hill, NC</aff>
<aff id="A2"><label>2</label>
School of Pharmacy, University of North Carolina, Chapel Hill, NC</aff>
<author-notes><corresp id="CR1"><label>*</label>
Address correspondence to Daniel E. Jonas, MD, MPH, Department of Medicine, 5034 Old Clinic Building, CB #7110, Chapel Hill, NC 27599-7110; telephone: (919) 966-7102; fax: (919) 966-1634; <email>daniel_jonas@med.unc.edu</email>
</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted"><day>17</day>
<month>9</month>
<year>2014</year>
</pub-date>
<pub-date pub-type="epub"><day>22</day>
<month>9</month>
<year>2009</year>
</pub-date>
<pub-date pub-type="ppub"><season>Mar-Apr</season>
<year>2010</year>
</pub-date>
<pub-date pub-type="pmc-release"><day>01</day>
<month>10</month>
<year>2014</year>
</pub-date>
<volume>30</volume>
<issue>2</issue>
<fpage>206</fpage>
<lpage>216</lpage>
<pmc-comment>elocation-id from pubmed: 10.1177/0272989X09343960</pmc-comment>
<abstract><sec id="S1"><title>Background</title>
<p id="P1">Most patients receiving warfarin are man- aged in outpatient office settings or anticoagulation clinics that require frequent visits for monitoring.</p>
</sec>
<sec id="S2"><title>Objective</title>
<p id="P2">To measure the amount and value of time required of patients for chronic anticoagulation therapy with warfarin.</p>
</sec>
<sec id="S3"><title>Design/Participants</title>
<p id="P3">Prospective observation of a cohort of adult patients treated at a university-based anticoagulation program.</p>
</sec>
<sec id="S4"><title>Measurements</title>
<p id="P4">Participants completed a questionnaire and a prospective diary of the time required for 1 visit to the anticoagulation clinic, including travel, waiting, and the clinic visit. The authors reviewed subjects’ medical records to obtain additional information, including the frequency of visits to the anti- coagulation clinic. They used the human capital method to estimate the value of time.</p>
</sec>
<sec id="S5"><title>Results</title>
<p id="P5">Eighty-five subjects completed the study. The mean (median) total time per visit was 147 minutes (123). Subjects averaged 15 visits per year (14) and spent 39.0 hours (29.3) per year on their visits. Other anticoagulation-related activities, such as communication with providers, pharmacy trips, and extra time preparing food, added an average of 52.7 hours (19.0) per year. The mean annual value of patient time spent traveling, waiting, and attending anticoagulation visits was $707 (median $591). The mean annual value when also including other anticoagulation-related activities was $1799 (median $1132).</p>
</sec>
<sec id="S6"><title>Conclusions</title>
<p id="P6">The time required of patients for anticoagulation visits was considerable, averaging approximately 2.5 hours per visit and almost 40 hours per year. Methods for reducing patient time requirements, such as home-based testing, could reduce costs for patients, employers, and companions.</p>
</sec>
</abstract>
<kwd-group><kwd>anticoagulation</kwd>
<kwd>warfarin</kwd>
<kwd>time</kwd>
<kwd>human capital method</kwd>
<kwd>health economics</kwd>
</kwd-group>
</article-meta>
</front>
</pmc>
</record>
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