ArticleJournal of the American Geriatrics Society2010
The quality of warfarin prescribing and monitoring in Veterans Affairs nursing homes.
Article in Journal of the American Geriatrics Society, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 21 citations in OpenAlex.
- Magnitudes of Risk Factors of Venous Thromboembolism and Quality of Anticoagulant Therapy in Ethiopia: A Systematic Review.Vascular health and risk management · 2022Pooled it
- Use of warfarin in long-term care: a systematic review.BMC geriatrics · 2012Pooled it
- Time in the therapeutic range, bleeding event, and their determinants in older patients with atrial fibrillation on warfarin in Ethiopia: multicenter cross-sectional study.Frontiers in pharmacology · 2025Article
- Rosendaal linear interpolation method appraising of time in therapeutic range in patients with 12-week follow-up interval after mechanical heart valve replacement.Frontiers in cardiovascular medicine · 2022Article
- Impact of an extended International Normalized Ratio follow-up interval on healthcare use among veteran patients on stable warfarin doses.American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists · 2019Article
- Quality of anticoagulation management with warfarin among outpatients in a tertiary hospital in Addis Ababa, Ethiopia: a retrospective cross-sectional study.BMC health services research · 2017Article
- Use of vitamin K antagonist therapy in geriatrics: a French national survey from the French Society of Geriatrics and Gerontology (SFGG).Drugs & aging · 2013Article
- Postdischarge international normalized ratio testing and long-term clinical outcomes of patients with heart failure receiving warfarin: findings from the ADHERE registry linked to Medicare claims.Clinical cardiology · 2013Article
- Risk versus benefit of non-vitamin K dependent anticoagulants compared to warfarin for the management of atrial fibrillation in the elderly.Drugs & aging · 2013Review
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Authors and funding
16 authors at 8 institutions in 2 countries.
Funding
Abstract
objectivesTo describe the quality of warfarin prescribing and monitoring in Veterans Affairs (VA) nursing homes and to assess the factors associated with maintaining a therapeutic international normalized ratio (INR).
designRetrospective cohort.
settingFive VA nursing homes.
participantsAll veterans who received warfarin between January 1 and June 30, 2008, at the nursing homes. MEASUREMENTS: Using medical records, the percentage of person-time spent in the target INR range, the proportion of patients with INRs in the therapeutic range on 50% or more of their person-days, and the frequency of INR monitoring were estimated. Multivariable logistic regression was used to identify factors associated with maintaining a therapeutic INR 50% or more of the time.
resultsOver 6 months, 160 patients received 10,380 person-days of warfarin. INRs were in the therapeutic range for 55% of the person-days, and 99% of the INR tests were repeated within 4 weeks of the previous result. On an individual level, 49% of patients had INRs in the target range for 50% or more of their person-days. Achieving this outcome was more likely in patients with prevalent warfarin use than with new use (adjusted odds ratio (AOR)=2.86, 95% confidence interval (CI)=1.06-7.72). Conversely, patients with a history of a stroke (AOR=0.38, 95% CI =0.18-0.80) were less likely to have therapeutic INRs for 50% or more of their days.
conclusionWarfarin appears to be prescribed and monitored effectively in VA nursing home patients. Future studies should focus on increasing time in therapeutic range in patients with poor INR control.
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