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Evaluation time in therapeutic range (TTR) of patient in warfarin medication therapy adherence clinic (MTAC) in Hospital Putrajaya / Noor Fadzillah Ariffin

Background: Warfarin is the most commonly used oral anticoagulant and has a narrow therapeutic window therefore requires frequent monitoring to maintain the desired treatment targets. Time in therapeutic range (TTR) usually use to identify the quality of INR control in patient with oral anticoagulan...

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Main Author: Ariffin, Noor Fadzillah
Format: Thesis
Language:English
Published: 2016
Subjects:
Infectious and parasitic diseases
Specialties of internal medicine
Online Access:http://ir.uitm.edu.my/id/eprint/26116/1/TM_NOOR%20FADZILLAH%20ARIFFIN%20PH%2016_5.pdf
http://ir.uitm.edu.my/id/eprint/26116/
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spelling my.uitm.ir.261162019-10-14T00:31:02Z http://ir.uitm.edu.my/id/eprint/26116/ Evaluation time in therapeutic range (TTR) of patient in warfarin medication therapy adherence clinic (MTAC) in Hospital Putrajaya / Noor Fadzillah Ariffin Ariffin, Noor Fadzillah Infectious and parasitic diseases Specialties of internal medicine Background: Warfarin is the most commonly used oral anticoagulant and has a narrow therapeutic window therefore requires frequent monitoring to maintain the desired treatment targets. Time in therapeutic range (TTR) usually use to identify the quality of INR control in patient with oral anticoagulant. We examined the status of and factor influence TTR and also bleeding and thromboembolic event in warfarin MTAC patients. Methods: We enrolled 162 patients from warfarin MTAC patients list. Patient‘s data were accessed retrospectively through electronic medical records. TTR was calculated using the linear interpolation technique. Descriptive data were analysed using frequency and percentage. Simple logistic regression was used for univariate analyses. Result: The mean of the individual‘s TTR calculated by using the Rosendaal method was 76%, (SD 18.5%) and only 24% of the INR value was out of the target range. Overall percentage of bleeding event would be 11.7% and percentage of thromboembolic events was only around 0.6%. Overall out of 162 patients, 135 patients show the TTR value is more than 60% and only 27 patients the TTR value less than 60%.TTR was not affected by age, gender, sex, race, indications, duration of warfarin, weekly dose and number of concurrent medication. Missed dose was the only statistical significant predictor of poor TTR value (P < 0.001). In patient with missed dose of warfarin has a 2.2 times more likely of having TTR value less than 60% with 95% confident interval (1.50 to 3.12). Conclusion: TTR is generally high in pharmacist managed clinic patients. The INR value most of time was spent within the target ranges. Thus, reflecting a good INR control in pharmacist managed clinic. 2016 Thesis NonPeerReviewed text en http://ir.uitm.edu.my/id/eprint/26116/1/TM_NOOR%20FADZILLAH%20ARIFFIN%20PH%2016_5.pdf Ariffin, Noor Fadzillah (2016) Evaluation time in therapeutic range (TTR) of patient in warfarin medication therapy adherence clinic (MTAC) in Hospital Putrajaya / Noor Fadzillah Ariffin. Masters thesis, Universiti Teknologi MARA.
institution Universiti Teknologi Mara
building Tun Abdul Razak Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Teknologi Mara
content_source UiTM Institutional Repository
url_provider http://ir.uitm.edu.my/
language English
topic Infectious and parasitic diseases
Specialties of internal medicine
spellingShingle Infectious and parasitic diseases
Specialties of internal medicine
Ariffin, Noor Fadzillah
Evaluation time in therapeutic range (TTR) of patient in warfarin medication therapy adherence clinic (MTAC) in Hospital Putrajaya / Noor Fadzillah Ariffin
description Background: Warfarin is the most commonly used oral anticoagulant and has a narrow therapeutic window therefore requires frequent monitoring to maintain the desired treatment targets. Time in therapeutic range (TTR) usually use to identify the quality of INR control in patient with oral anticoagulant. We examined the status of and factor influence TTR and also bleeding and thromboembolic event in warfarin MTAC patients. Methods: We enrolled 162 patients from warfarin MTAC patients list. Patient‘s data were accessed retrospectively through electronic medical records. TTR was calculated using the linear interpolation technique. Descriptive data were analysed using frequency and percentage. Simple logistic regression was used for univariate analyses. Result: The mean of the individual‘s TTR calculated by using the Rosendaal method was 76%, (SD 18.5%) and only 24% of the INR value was out of the target range. Overall percentage of bleeding event would be 11.7% and percentage of thromboembolic events was only around 0.6%. Overall out of 162 patients, 135 patients show the TTR value is more than 60% and only 27 patients the TTR value less than 60%.TTR was not affected by age, gender, sex, race, indications, duration of warfarin, weekly dose and number of concurrent medication. Missed dose was the only statistical significant predictor of poor TTR value (P < 0.001). In patient with missed dose of warfarin has a 2.2 times more likely of having TTR value less than 60% with 95% confident interval (1.50 to 3.12). Conclusion: TTR is generally high in pharmacist managed clinic patients. The INR value most of time was spent within the target ranges. Thus, reflecting a good INR control in pharmacist managed clinic.
format Thesis
author Ariffin, Noor Fadzillah
author_facet Ariffin, Noor Fadzillah
author_sort Ariffin, Noor Fadzillah
title Evaluation time in therapeutic range (TTR) of patient in warfarin medication therapy adherence clinic (MTAC) in Hospital Putrajaya / Noor Fadzillah Ariffin
title_short Evaluation time in therapeutic range (TTR) of patient in warfarin medication therapy adherence clinic (MTAC) in Hospital Putrajaya / Noor Fadzillah Ariffin
title_full Evaluation time in therapeutic range (TTR) of patient in warfarin medication therapy adherence clinic (MTAC) in Hospital Putrajaya / Noor Fadzillah Ariffin
title_fullStr Evaluation time in therapeutic range (TTR) of patient in warfarin medication therapy adherence clinic (MTAC) in Hospital Putrajaya / Noor Fadzillah Ariffin
title_full_unstemmed Evaluation time in therapeutic range (TTR) of patient in warfarin medication therapy adherence clinic (MTAC) in Hospital Putrajaya / Noor Fadzillah Ariffin
title_sort evaluation time in therapeutic range (ttr) of patient in warfarin medication therapy adherence clinic (mtac) in hospital putrajaya / noor fadzillah ariffin
publishDate 2016
url http://ir.uitm.edu.my/id/eprint/26116/1/TM_NOOR%20FADZILLAH%20ARIFFIN%20PH%2016_5.pdf
http://ir.uitm.edu.my/id/eprint/26116/
_version_ 1685650093945913344
score 13.211869

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