IPRO Researchers Examine Warfarin Safety

New regulations and reimbursement changes may be necessary in view of findings of sub-optimal management of nursing homes patients receiving warfarin and interacting antibiotics simultaneously, according to a new study by pharmacy experts at IPRO. Researchers examined warfarin management at 12 randomly selected long-term care facilities and found timely International Normalized Ratio (INR) testing in only 70% of 207 instances of warfarin-antibiotic coprescribing. Warfarin time in therapeutic range (TTR) across facilities was only 45.5% (range 34.1% to 61.8%). Only three facilities entered the study with TTRs greater than 50%, and three facilities had TTRs below 40%. Warfarin is prescribed to an estimated 12% of all 1.6 million Americans in long-term care facilities, with 34,000 warfarin-related adverse events occurring annually, many of them preventable. According to the authors: “If facilities are unwilling or unable to voluntarily implement known best practices for anticoagulation management, then changes to regulations and reimbursement systems are warranted.” “Improving Warfarin Safety in Long-Term Care” by Darren Triller, PharmD; Susan Wymer; Karen Morris; Gayle Farman and Anne Myrka appears in the July 2014 edition of The Consultant Pharmacist (vol 29, No. 7), published by the American Society of Consultant Pharmacists. For reprints contact the journal at www.ascp.com.