Sánchez-Garrido Escudero Ramón, Molina Casado María Plácida, Rodríguez Idígoras María Isabel, Martínez González José Luis, Escolar Castellón José Luis
Unidad de Calidad. Delegación de Salud de Málaga. España.
Aten Primaria. 2006 Nov 15;38(8):427-32. doi: 10.1157/13094796.
To estimate the prevalence of drugs that interact with oral anticoagulants and establish relationships between variables and haemorrhagic complications.
Longitudinal, retrospective study of patient anticoagulant.
Colmenar basic health area, Malaga, Spain.
Patients on anticoagulants followed up in primary care.
Indications, time of follow-up, value of last prothrombin time (INR), complications and therapeutic groups of major use.
The 74.2% of the patients had a prothrombin time (INR) in the therapeutic range; 16.14% had minor complications; 60.2% of the patients complied with the criteria of multiple medication and 88.2% complied with the criteria of multiple medication in the last 6 months. The drugs used with a higher capacity to interact are: anti-ulcer (26.9%), locomotor system (10.7%), cardiovascular drugs (2.2%), lipid lowering drugs (8.6%), and antidiabetics (17.2%). The number of drugs used in the last 6 months is associated with the presence of haemorrhagic complications (odds ratio [OR], 1.10). Allopurinol and pantoprazole had a significant relationship with the presence of minor haemorrhages (OR, 19.25 and 7.37, respectively). The variables associated with the presence of a haemorrhage were: allopurinol (OR, 25.84), number of controls with an INR outside the therapeutic range in the last 6 months (OR, 1.31) and time on treatment (OR, 1.07).
The percentage of patients within the therapeutic range in the last determination of INR indicates good quality. The number of minor complications exceeded the consensus standard for the control of patients on anticoagulants. The use of drugs with a higher capacity for interacting with oral anticoagulants was very high in the anti-ulcer and antidiabetic groups. Pharmacological control of patients on anticoagulants is necessary and multiple medications should be avoided.
评估与口服抗凝剂相互作用的药物的流行情况，并确定变量与出血并发症之间的关系。
对患者抗凝剂进行纵向回顾性研究。
西班牙马拉加科尔梅纳尔基本卫生区。
在初级保健中接受抗凝治疗的患者。
适应证、随访时间、最后一次凝血酶原时间（国际标准化比值[INR]）值、并发症和主要使用的治疗组。
74.2%的患者凝血酶原时间（INR）在治疗范围内；16.14%有轻微并发症；60.2%的患者符合多重用药标准，88.2%的患者在过去6个月内符合多重用药标准。相互作用能力较高的药物有：抗溃疡药（26.9%）、运动系统药（10.7%）、心血管药物（2.2%）、降脂药（8.6%）和抗糖尿病药（17.2%）。过去6个月使用的药物数量与出血并发症的发生有关（比值比[OR]，1.10）。别嘌醇和泮托拉唑与轻微出血的发生有显著关系（OR分别为19.25和7.37）。与出血发生相关的变量有：别嘌醇（OR，25.84）、过去6个月内INR超出治疗范围的检查次数（OR，1.31）和治疗时间（OR，1.07）。
在最后一次INR测定中处于治疗范围内的患者百分比表明质量良好。轻微并发症的数量超过了抗凝治疗患者控制的共识标准。抗溃疡和抗糖尿病组中与口服抗凝剂相互作用能力较高的药物使用非常普遍。对抗凝治疗患者进行药理控制是必要的，应避免多重用药。
