Warfarin-related adverse events remain too common


Warfarin-related adverse events remain common in hospitalized patients according to a new study published in the Journal of Hospital Medicine.

The study, titled “Predictors of Warfarin-Associated Adverse Events in Hospitalized Patients: Opportunities to Prevent Patient Harm,” was conducted by Qualidigm, the a healthcare consulting company in partnership with the Agency for Healthcare Research and Quality (AHRQ), the Centers for Medicare & Medicaid Services (CMS), and other national leading institutions.

The researchers used medical record data of Medicare patients who are 65 and older from the Medicare Patient Safety Monitoring System, the nation’s largest randomly selected medical record abstraction-based database designed for patient safety tracking.

The study, which was funded through the AHRQ, assessed the frequency of international normalized ratio (INR) testing to monitor the effectiveness of warfarin, and its relationship to over-anticoagulation and warfarin-related adverse events.

“The results of this study show that the INR was not always monitored daily, and lack of daily monitoring was associated with over-anticoagulation and bleeding adverse events,” said Dr Mark Metersky, lead author of the study and also a professor of medicine in the Division of Pulmonary and Critical Care Medicine at the University of Connecticut School of Medicine.

“The observed lapses in daily INR monitoring may in part be due to the absence of evidence or guidance on how often the INR should be monitored in patients receiving warfarin in the hospital. We hope that the evidence of a relationship between less than daily INR monitoring and bleeding events will lead to improved practices and safer care for hospitalized patients.”

Qualidigm president and CEO Tim Elwell added: “Improving patient safety in the hospitals starts with determining the root causes for adverse events. Qualidigm has been working on patient safety since 2001. We are pleased that this study has revealed yet another evidence-based practice that can improve care for hospitalized patients.”

Qualidigm, Dr Mark Metersky, University of Connecticut School of Medicine,Tim Elwell, US