Anticoagulation

Anticoagulation in Practice: Why it Matters that the Dose of Warfarin is Spot On

More and more nurses in primary care are involved in monitoring international normalised ratio (INR) levels and advising patients on warfarin doses as anticoagulation clinics move out of secondary care and into primary care. In this article we explore why warfarin is prescribed, how to monitor patients on the drug and what to look out for in terms of interactions with prescribed medicines, over-the-counter drugs and foods. We also need to be able to advise on lifestyle interventions that go hand-in-hand with taking warfarin.

Understanding the Potential of New Oral Anticoagulant Drugs

Although there are other oral anticoagulation agents available, warfarin is the drug used predominantly in the UK. Warfarin has been in clinical use for over 50 years. It is still referred to by patients as ‘rat poison’ and,indeed, warfarin derivatives are still used as rodenticides.In this article, we take a look at some of the new oral anticoagulants coming along.

Are new oral anticoagulant drugs set to transfer provision of anticoagulation services to primary care?

You and your treatment: starting on warfarin

Blood Clotting: How do Drugs Affect it?

Haemostasis is essentially the fine balance between activators and inhibitors that control the production of the protein tangle that makes up a blood clot. A range of drugs can interfere with this fine balance. In this article we guide you through the latest theories of how blood clotting occurs and explain how various drugs used as anticoagulants interfere with this normal haemostatic mechanism.

Stop the clot: achieving effective anticoagulation in patients with heart disease

Thromboembolism is a common complication of heart disease – particularly in patients with atrial fibrillation (AF). Decisions to prescribe an anticoagulant are based on assessment of an individual patient’s risk of clotting and the side-effects of treatment. With growing numbers of patients with heart disease, the number of patients on anticoagulants is increasing and there is a shift to primary care-based anticoagulation clinics. Practice nurses have a central role in educating patients about anticoagulation therapy and in monitoring their ongoing care.

What patients think about long-term anticoagulant therapy

Effective long-term anticoagulation requires a good working partnership between patients and the healthcare team. A key part of this is that patients understand how their treatment works, why it has been given and how to take it correctly. AntiCoagulation Europe, a patient organisation for people on anticoagulants, recently carried out a survey of 711 patients with atrial fibrillation (AF) from seven European countries (France, Germany, Italy, Norway, Spain, Sweden and the UK) being treated with a vitamin K antagonist (VKA) such as warfarin. The it’s about time survey was designed to explore patients’ insights into their treatment. The results show that many patients have gaps in their understanding about anticoagulation therapy and emphasise the need for ongoing patient education and the development of more patient-friendly anticoagulants to improve outcomes and quality of life.

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