Margolis A, Flores F, Kierszenbaum M, Cavallo Z, Botti B, D'Ottone E, Tavella N, Torres J
Clínica Médica C, Hospital de Clínicas, Montevideo, Uruguay.
Proc Annu Symp Comput Appl Med Care. 1994:846-50.
Warfarin 2.0 is a computer program that helps physicians optimize treatment of outpatients with warfarin. The main reason for its development was to achieve a good anticoagulation level, avoiding both undertreatment--which causes thromboembolic complications--and overtreatment--which causes hemorrhagic complications. The program was also designed to help educate the anticoagulated patient, standardize warfarin management and audit results of what had been done. The philosophy of continuous quality improvement was applied. Warfarin 2.0 is in clinical operation in the University Hospital, Montevideo, Uruguay, and it has also been used since the end of 1993 in the Favaloro Foundation, Dept. of Hematology, Buenos Aires, Argentina. The results from the first 15 months of use in Montevideo showed an increase in the number of patients being followed (from 91 to 132) and the average number of visits per patient (from one visit every 10.6 weeks to one every 6.5 weeks): The frequency of visits has been in the internationally accepted ranges since the program was implemented. Better anticoagulation levels were achieved after an adjusting period. Unfortunately, the number of undertreated patients is still large, and a thorough analysis of the data is going to be undertaken to continue improving warfarin management.
华法林2.0是一个计算机程序，可帮助医生优化对华法林门诊患者的治疗。开发该程序的主要原因是要达到良好的抗凝水平，避免治疗不足（会导致血栓栓塞并发症）和过度治疗（会导致出血并发症）。该程序还旨在帮助教育接受抗凝治疗的患者，规范华法林管理并审核已开展工作的结果。应用了持续质量改进的理念。华法林2.0已在乌拉圭蒙得维的亚大学医院投入临床使用，自1993年底以来也一直在阿根廷布宜诺斯艾利斯法瓦洛罗基金会血液科使用。在蒙得维的亚使用的前15个月的结果显示，接受随访的患者数量有所增加（从91例增至132例），每位患者的平均就诊次数也有所增加（从每10.6周就诊一次增至每6.5周就诊一次）：自该程序实施以来，就诊频率一直处于国际公认的范围内。经过调整期后，达到了更好的抗凝水平。不幸的是，治疗不足的患者数量仍然很多，将对数据进行全面分析以继续改进华法林管理。
