ArticleBMC health services research2015
Effect of distance to health facility on the maintenance of INR therapeutic ranges in rheumatic heart disease patients from Cape Town: no evidence for an association.
Article in BMC health services research, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Anticoagulation control among patients on vitamin K antagonists in nine countries in Sub-Saharan Africa.Journal of thrombosis and thrombolysis · 2024Article
- Article
- The role of causal knowledge in stigma considerations in African genomics research: Views of South African Xhosa people.Social science & medicine (1982) · 2021Article
- Rationale and design of the African group A streptococcal infection registry: the AFROStrep study.BMJ open · 2016Article
- Predictors of warfarin non-adherence in younger adults after valve replacement surgery in the South Pacific.Heart Asia · 2016Article
- PASCAR and WHF Cardiovascular Diseases Scorecard project.Cardiovascular journal of AfricaArticle
- Incidence and risk factors for thromboembolism and major bleeding in patients with mechanical heart valves: a tertiary hospital-based study in Botswana.Cardiovascular journal of AfricaArticle
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Authors and funding
6 authors.
Funding
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Abstract
backgroundLack of adherence to international normalised ratio (INR) monitoring in rheumatic heart disease (RHD) patients is a contributor to cardio-embolic complications. This population-based observational study investigated whether the distance between home and an INR clinic affects the maintenance of therapeutic INR in RHD patients on warfarin.
methodsResidential addresses, INR clinics, and INR results of patients with RHD were extracted from the Cape Town component of the Global Rheumatic Heart Disease Registry (REMEDY) database. Addresses of homes and INR clinics were converted to geographical coordinates and verified in ArcGIS 10®. ArcGIS 10® and Google Maps® were used for spatial mapping and obtaining shortest road distances respectively. The travel distance between the home and INR clinic was correlated with time within therapeutic range (TTR) using the Rosendaal linear interpolation method, and with the fraction of INR within range, based on an average of three INR readings of patients and compared with recommended therapeutic ranges.
resultsRHD patients (n = 133) resided between 0.2 km and 50.8 km (median distance, 3.60 km) from one of 33 INR clinics. There was no significant difference in the achievement of the therapeutic INR between patients who travelled a shorter distance compared to those who travelled a longer distance (in range = 3.50 km versus out of range = 3.75 km, p = 0.78). This finding was the same for patients with mechanical valve replacement (n = 105) (3.50 km versus 3.90 km, p = 0.81), and native valves (3.45 km versus 2.75 km, p = 0.84).
conclusionsThere is no association between the maintenance of INR within therapeutic range amongst RHD patients in Cape Town and distance from patients' residence to the INR clinic.
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