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dc.contributor.authorBernaitis, Nijole
dc.contributor.authorBadrick, Tony
dc.contributor.authorDavey, Andrew K
dc.contributor.authorCrilly, Julia
dc.contributor.authorAnoopkumar-Dukie, Shailendra
dc.date.accessioned2019-05-29T13:14:43Z
dc.date.available2019-05-29T13:14:43Z
dc.date.issued2018
dc.identifier.issn0929-5305
dc.identifier.doi10.1007/s11239-018-1719-x
dc.identifier.urihttp://hdl.handle.net/10072/381994
dc.description.abstractWarfarin has long been the most widely prescribed oral anticoagulant. Introduction of non-vitamin K oral anticoagulants (NOACs) has provided anticoagulant options but also presented the potential challenge of transitioning between agents. Changes from NOACs to warfarin are particularly problematic with delays to therapeutic effect and limited real-world data regarding the impact on warfarin control. The aim of this study was to investigate the frequency of switching anticoagulants and the effect on warfarin control. Retrospective data was collected for patients at a warfarin program in Queensland Australia who had exited the program for NOACs plus those who had reverted to warfarin. Data included documented reasons for change and International Normalised Ratio (INR) results with time in therapeutic range (TTR) calculated as a measure of warfarin control. Over 5 years, a total of 3036 patients ceased warfarin to commence a NOAC but 142 (4.7%) reverted to warfarin. Majority of patients (60.6%) reverted to warfarin within 6 months of trialling NOACs with a median of 6 days to therapeutic INR. There was no significant difference in warfarin control before changing to NOACs and after reverting to warfarin (mean TTR 75%) but significantly more frequent testing and lower doses were required to achieve this control. Transitions from warfarin to NOACs results in almost a week to therapeutic effect and warfarin therapy may be further complicated by a need for increased frequency of testing. Further studies are required to refine transition strategies particularly from warfarin to NOAC and minimise potential risks to patients.
dc.description.peerreviewedYes
dc.languageEnglish
dc.language.isoeng
dc.publisherSpringer New York LLC
dc.publisher.placeUnited States
dc.relation.ispartofpagefrom461
dc.relation.ispartofpageto465
dc.relation.ispartofissue4
dc.relation.ispartofjournalJournal of Thrombosis and Thrombolysis
dc.relation.ispartofvolume46
dc.subject.fieldofresearchClinical sciences
dc.subject.fieldofresearchClinical sciences not elsewhere classified
dc.subject.fieldofresearchCardiovascular medicine and haematology
dc.subject.fieldofresearchcode3202
dc.subject.fieldofresearchcode320299
dc.subject.fieldofresearchcode3201
dc.titleWarfarin control in patients transitioning to warfarin after non-vitamin K oral anticoagulant (NOAC) therapy
dc.typeJournal article
dc.type.descriptionC1 - Articles
dc.type.codeC - Journal Articles
dc.description.versionAccepted Manuscript (AM)
gro.facultyGriffith Health, School of Pharmacy and Pharmacology
gro.rights.copyright© 2018 Springer US. This is an electronic version of an article published in Journal of Thrombosis and Thrombolysis, November 2018, Volume 46, Issue 4, pp 461–465. Journal of Thrombosis and Thrombolysis is available online at: http://link.springer.com/ with the open URL of your article.
gro.hasfulltextFull Text
gro.griffith.authorCrilly, Julia
gro.griffith.authorAnoopkumar-Dukie, Shailendra
gro.griffith.authorDavey, Andrew
gro.griffith.authorBernaitis, Nijole L.


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