Year : 2020 | Volume
: 152 | Issue : 3 | Page : 303--307
Quality of anticoagulation with warfarin in rural Chhattisgarh, India
Puja Chebrolu1, Sushil Patil2, Timothy S Laux3, Noor Al-Hammadi4, Yogesh Jain2, Brian Gage1
1 Department of Medicine, Washington University in St. Louis, Missouri, USA
2 Jan Swasthya Sahyog, Chhattisgarh, India
3 Department of Hospital Medicine, Columbia University Medical Center, New York, USA
4 Division of Biostatistics, Washington University in St. Louis, St. Louis, Missouri, USA
Background & objectives: In most of rural India, warfarin is the only oral anticoagulant available. Among patients taking warfarin, there is a strong association between poor control of the international normalized ratio (INR) and adverse events. This study was aimed to quantify INR control in a secondary healthcare system in rural Chhattisgarh, India.
Methods: The INR data were retrospectively obtained from all patients taking warfarin during 2014-2016 at a secondary healthcare system in rural Chhattisgarh, India. Patients attending the clinic had their INR checked at the hospital laboratory and their warfarin dose adjusted by a physician on the same day. The time in therapeutic range (TTR) was calculated for patients who had at least two INR visits.
Results: The 249 patients had 2839 INR visits. Their median age was 46 yr, and the median body mass index was 17.7 kg/m. They lived a median distance of 78 km (2-3 h of travel) from the hospital. The median INR was 1.7 for a target INR of 2.0-3.0 (n=221) and 2.1 for a target of 2.5-3.5 (n=28). The median TTR was 13.0 per cent, and INR was subtherapeutic 66.0 per cent of the time. Distance from the hospital was not correlated with TTR.
Interpretation & conclusions: INR values were subtherapeutic two-thirds of the time, and TTR values were poor regardless of distance from the health centre. Future studies should be done to identify interventions to improve INR control.
Dr Puja Chebrolu
7595 River Crest Dr, Columbus, GA 31904
|How to cite this article:|
Chebrolu P, Patil S, Laux TS, Al-Hammadi N, Jain Y, Gage B. Quality of anticoagulation with warfarin in rural Chhattisgarh, India.Indian J Med Res 2020;152:303-307
|How to cite this URL:|
Chebrolu P, Patil S, Laux TS, Al-Hammadi N, Jain Y, Gage B. Quality of anticoagulation with warfarin in rural Chhattisgarh, India. Indian J Med Res [serial online] 2020 [cited 2020 Nov 25 ];152:303-307
Available from: https://www.ijmr.org.in/article.asp?issn=0971-5916;year=2020;volume=152;issue=3;spage=303;epage=307;aulast=Chebrolu;type=0