Comparison of two approaches of INR-follow-up and determinants of INR-stability. Issue 3 (June 2015)

• Record Type: Journal Article
• Authors: Desmaele, S.; Dupont, A. G.; Putman, K.; Cornu, P.; Steurbaut, S.
• Is Part Of: Acta clinica belgica. Volume 70:Issue 3(2015)
• Page Start: 167
• Page End: 174
• Publication Date: 2015-06
• Subjects: Clinical medicine -- Periodicals; Diagnosis, Laboratory -- Periodicals; 616.005
• DOI: 10.1179/2295333714Y.0000000117
• Languages: German
• ISSNs: 1784-3286

Abstract

<abstract> <title> <x content-type="archive" xml:space="preserve">Abstract</x> </title> <sec> <title>Introduction:</title> <p>Patients with atrial fibrillation (AF) and treated with coumarins need a close follow-up of the international normalized ratio (INR)-values. This can be done by the general practitioner (GP) or by a haematologist in an outpatient hospital clinic.</p> </sec> <sec> <title>Objective:</title> <p>To compare both ways of follow-up and to investigate determinants of stable INR-patterns.</p> </sec> <sec> <title>Methods:</title> <p>Cross-sectional single-centre study in patients with AF treated at the UZ Brussel, a university hospital in Brussels. Of the 113 patients included in the study, 71 had their INR followed-up by their GP and 42 similar patients were followed-up by a haematologist. Data of these 113 patients were further analysed to identify possible determinants for stable INR-values.</p> </sec> <sec> <title>Results:</title> <p>The time in therapeutic range (TTR) did not significantly differ between both groups. However, patients in the GP-group had significantly more INR-values under 2·0 compared to patients from the haematologist-group (<italic>P</italic> = 0·044), whereas patients in the haematologist-group had significantly more INR-values above 3·0 compared to patients from the GP-group (<italic>P</italic> = 0·038). Reimbursement costs of both ways of follow-up were comparable, but the out-of-pocket costs for the patient were lower in the GP-group. The time since AF diagnosis was the only significant determinant predicting a higher TTR.</p> </sec> <sec> <title>Conclusion:</title> <p>Both approaches of follow-up seem to lead to the same TTR, yielding no reason to advocate one approach above the other. However, the patient costs were lower when followed-up by the GP.</p> </sec> </abstract>