The Outcome of Development of Warfarin Safety Monitoring System in Primary Care

Abstract

Objective: To evaluate the warfarin safety monitoring system in primary care. Research method: Quasi-experimental research to study the size of the problem and compare problems related to warfarin use in the community. INR control efficiency and safety in 100 patients. Results: Warfarin leftover problem at home decreased from 46.46% to 7%(p<0.001). Improper medicine storage decreased from 37.37% to 6%%(p<0.001). Herbal and dietary supplement use decreased from 17.31% to 2%%(p<0.001). The chance of drug interaction problems decreased from 84.85% to 71%(p=0.187). Problems with adverse reactions from warfarin decreased from 13.14% to 5%(p=0.143). Patients who did not arrive on their appointment date decreased from33.65% to 9%(p<0.001) and not found patients missing appointments. The percentage of compliance in drug use increased from 91.14% to 93.75% (p=0.165). Efficacy and safety results from the use of warfarin were found to be the percentage of patients receiving warfarin who received the Target INR increased from 44.83% to 48.70%, the percent Stroke Rate in Warfarin Clinic decreased from 0.44% to not found, and the percentage of Major bleeding from Warfarin Clinic decreased from 0.27% to not found in 2023. Conclusion: This study shows that after developing a system for monitoring the safety of warfarin use in primary care and using it in patient care. This system can reduce problems related to warfarin and increase safety from using warfarin and the patient can better control the blood coagulation value (INR) within the target.

Key words : Warfarin, Primary care, INR, Chronic Care Model