Med J Aust. 1998 Sep 7;169(5):243-6.
To examine the effectiveness of anticoagulation among patients discharged from hospital on warfarin in the care of general practitioners (GPs).
A historical cohort with questionnaires to patients discharged from a major metropolitan teaching hospital and their GPs.
Patients discharged between 1 February 1995 and 31 January 1996 identified from hospital pharmacy records as being prescribed warfarin, and their treating GPs.
Frequency of testing and levels of international normalised ratio of prothrombin time (INR) within six months of discharge; level of INR aimed at by GP; complication rates; and patient knowledge about anticoagulation.
Replies were received from 242 (68%) patients and pathology records were examined for 195 (81%) of these. The median gap between INR measures was seven days. The median of the median INR level for each patient was 2.4 (rising to 2.7 in patients with an artificial heart valve); 24% of observed patient time was spent at an INR level of less than 2.0, 54% between 2.0 and 2.9, 18% between 3.0 and 3.9 and 4% at an INR level of 4.0 or more. There were five confirmed major complications (equivalent to 5 per 100 patient-years). Twenty-seven per cent of patients answered at least eight of the 10 knowledge questions correctly: education level predicted knowledge, but there was no relationship between knowledge and INR level.
Among this unselected group of patients whose anticoagulation was managed by GPs, there was a high frequency of laboratory testing. INR levels were controlled safely and complication rates were comparable with those in published reports.
研究在全科医生（GP）的护理下，出院时服用华法林的患者接受抗凝治疗的效果。
一项历史性队列研究，对一家大型都市教学医院出院的患者及其全科医生进行问卷调查。
从医院药房记录中确定的1995年2月1日至1996年1月31日期间出院且正在服用华法林的患者及其主治全科医生。
出院后六个月内凝血酶原时间国际标准化比值（INR）的检测频率和水平；全科医生设定的INR目标水平；并发症发生率；以及患者对抗凝治疗的了解情况。
收到了242名（68%）患者的回复，并对其中195名（81%）患者的病理记录进行了检查。INR检测之间的中位间隔时间为七天。每位患者INR水平中位数的中位数为2.4（人工心脏瓣膜患者升至2.7）；观察到的患者时间中有24%处于INR水平低于2.0，54%处于2.0至2.9之间，18%处于3.0至3.9之间，4%处于INR水平4.0或更高。有5例确诊的严重并发症（相当于每100患者年5例）。27%的患者在10个知识问题中至少答对8个：教育水平可预测知识，但知识与INR水平之间没有关系。
在这组由全科医生管理抗凝治疗的未经过筛选的患者中，实验室检测频率较高。INR水平得到了安全控制，并发症发生率与已发表报告中的相当。
