Ageno W, Johnson J, Nowacki B, Turpie A G
Hamilton Health Sciences Corporation, General Division, McMaster University, Ontario, Canada.
Thromb Haemost. 2000 Jun;83(6):849-52.
There is an increasing use of computer-based dosage programs to monitor oral anticoagulant therapy in outpatients. DAWN AC INDUCTION by 4S, UK, is a computer generated system to initiate oral anticoagulant therapy providing fast access to the maintenance program. This method of initiation of anticoagulant therapy has not been validated. We therefore randomized 50 hospitalized patients starting oral anticoagulation to control by the computer and 51 by manual dosing using a dosing schedule based on a locally defined algorithm. After a 7 days follow up, the daily mean INR was 2.09 and 2.07 and the proportion of dose adjustments was 48% and 45% in the computer and manually controlled groups respectively. Twenty-eight % of the patients monitored by the computer system required at least one manual overriding. DAWN AC INDUCTION provided a simple and accurate organization of the data, with an overall quality comparable to that of the manual system. Furthermore, the induction programme provided simple access to the maintenance programme. Although it required careful monitoring, the programme resulted in a significant saving in personnel time.
在门诊患者中，基于计算机的剂量程序越来越多地用于监测口服抗凝治疗。英国4S公司的DAWN AC INDUCTION是一个计算机生成的系统，用于启动口服抗凝治疗，可快速进入维持程序。这种启动抗凝治疗的方法尚未得到验证。因此，我们将50名开始口服抗凝治疗的住院患者随机分为两组，一组通过计算机控制，另一组通过基于当地定义算法的给药方案进行手动给药。经过7天的随访，计算机控制组和手动控制组的每日平均国际标准化比值（INR）分别为2.09和2.07，剂量调整比例分别为48%和45%。在计算机系统监测的患者中，28%至少需要一次人工干预。DAWN AC INDUCTION提供了简单而准确的数据组织，总体质量与手动系统相当。此外，诱导程序提供了进入维持程序的简单途径。虽然它需要仔细监测，但该程序显著节省了人员时间。
