Grado de control del tratamiento anticoagulante oral en los centros de Atención Primaria de la Comunidad de Madrid: estudio CHRONOS-TAO

Translated title of the contribution: Quality control of oral anticoagulant therapy in Primary Care in Madrid City, Spain: CHRONOS-TAO study

Rafael Alonso Roca, Carmen Arlene Figueroa Guerrero, Victoria Mainar De Paz, M. Paz Arribas García, Luis Sánchez Perruca, Ricardo Rodríguez Barrientos, Mariano Casado López, Ana M. Pedraza Flechas

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

Objectives To determine quality control of patients with oral anticoagulant treatment recruited in Primary Care (PC) using the Rosendaal method to estimate time in therapeutic range (TTR) and comparing it with fraction of international normalized ratio (INR) in range and cross-sectional analysis (last INR registred). Material and method A retrospective observational study based on electronic medical record in routine clinical practice. Setting: PC centers (262) in Madrid. We included all patients with acenocumarol treatment, with an INR therapeutic range established between 2 and 3. We excluded patients with valvular pathology and disrupted clinical follow up in PC (< 3 INR determinations in the studied period, a period of > 90 days or ≤3 periods of > 60 days between 2 determinations). The final population was 49,312 patients. The variables considered were all INR values and their respective dates. TTR was calculated by the 3 methods above mentioned. We considered "therapeutic range" INR between 2-3 and "adjusted range" INR between 1.8-3.2. Optimal control for each patient was considered TTR > 60%. Results By using Rosendaal method, TTR was 66.8% (81.7% adjusted), with a percentage of total INR in range was 58.8% (66.5% adjusted), and, with the cross-sectional analysis, it was 70.5% (76.8% adjusted). Mean TTR was 65% (standard deviation 20.3), and the percentage of patients with TTR > 60% was 63.3% (88.1% adjusted). Conclusion The quality control of patients with oral anticoagulants in PC in Madrid is acceptable, similar or higher to other studies and pivotal trials of new anticoagulants. Compared to the Rosendaal method, total fraction of INR underestimates quality control, and cross-sectional analysis slightly overestimates it.

Translated title of the contributionQuality control of oral anticoagulant therapy in Primary Care in Madrid City, Spain: CHRONOS-TAO study
Original languageSpanish
Pages (from-to)192-197
Number of pages6
JournalMedicina Clinica
Volume145
Issue number5
DOIs
StatePublished - Sep 7 2015
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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