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Efficacy and safety of app-based remote warfarin management during COVID-19-related lockdown: a retrospective cohort study

This study aimed to explore the effectiveness, and safety of internet-based warfarin management during the pandemic. In this single-center retrospective cohort study, we compared the safety and efficacy of online warfarin management using a smartphone app (the Alfalfa app) versus conventional outpat...

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Detalles Bibliográficos
Autores principales: Jiang, Shaojun, Lv, Meina, Zeng, Zhiwei, Fang, Zongwei, Chen, Mingrong, Qian, Jiafen, Wu, Tingting, Chen, Wenjun, Zhang, Jinhua
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer US 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8799972/
https://www.ncbi.nlm.nih.gov/pubmed/35092566
http://dx.doi.org/10.1007/s11239-021-02630-0
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author Jiang, Shaojun
Lv, Meina
Zeng, Zhiwei
Fang, Zongwei
Chen, Mingrong
Qian, Jiafen
Wu, Tingting
Chen, Wenjun
Zhang, Jinhua
author_facet Jiang, Shaojun
Lv, Meina
Zeng, Zhiwei
Fang, Zongwei
Chen, Mingrong
Qian, Jiafen
Wu, Tingting
Chen, Wenjun
Zhang, Jinhua
author_sort Jiang, Shaojun
collection PubMed
description This study aimed to explore the effectiveness, and safety of internet-based warfarin management during the pandemic. In this single-center retrospective cohort study, we compared the safety and efficacy of online warfarin management using a smartphone app (the Alfalfa app) versus conventional outpatient clinic management from January 1, 2020 to March 31, 2020. Patients in the online management group used the Alfalfa app to communicate coagulation test results and other relevant information to a doctor or clinical pharmacist, who then responded with the dose adjustment plan and the date of the next blood test. The outcomes examined were the time in therapeutic range (TTR), incidence of clinical events (i.e., bleeding events, thrombotic events, warfarin-related emergency department visits, and warfarin-related hospital admissions), and the distribution of international normalized ratio (INR) values. Data from 117 patients were analyzed in this study. TTR was significantly higher in the online group than in the offline group (61.0% vs. 39.6%, P < 0.01). Incidence of major bleeding events, thrombotic events, and warfarin-related hospital admissions were comparable between the online and offline groups. However, minor bleeds (5.3% vs. 28.3%, P < 0.01) and warfarin-related emergency department visits (1.8% vs. 23.3%, P = 0.02) were significantly fewer in the online group than in the offline group. The proportion of INR values in the therapeutic range (53.8% vs. 40.1%, P < 0.01) was significantly higher in the online group. Warfarin management using the Alfalfa app appears to be a safe and effective method for warfarin management when patients cannot physically visit hospitals for follow-up. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11239-021-02630-0.
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spelling pubmed-87999722022-01-31 Efficacy and safety of app-based remote warfarin management during COVID-19-related lockdown: a retrospective cohort study Jiang, Shaojun Lv, Meina Zeng, Zhiwei Fang, Zongwei Chen, Mingrong Qian, Jiafen Wu, Tingting Chen, Wenjun Zhang, Jinhua J Thromb Thrombolysis Article This study aimed to explore the effectiveness, and safety of internet-based warfarin management during the pandemic. In this single-center retrospective cohort study, we compared the safety and efficacy of online warfarin management using a smartphone app (the Alfalfa app) versus conventional outpatient clinic management from January 1, 2020 to March 31, 2020. Patients in the online management group used the Alfalfa app to communicate coagulation test results and other relevant information to a doctor or clinical pharmacist, who then responded with the dose adjustment plan and the date of the next blood test. The outcomes examined were the time in therapeutic range (TTR), incidence of clinical events (i.e., bleeding events, thrombotic events, warfarin-related emergency department visits, and warfarin-related hospital admissions), and the distribution of international normalized ratio (INR) values. Data from 117 patients were analyzed in this study. TTR was significantly higher in the online group than in the offline group (61.0% vs. 39.6%, P < 0.01). Incidence of major bleeding events, thrombotic events, and warfarin-related hospital admissions were comparable between the online and offline groups. However, minor bleeds (5.3% vs. 28.3%, P < 0.01) and warfarin-related emergency department visits (1.8% vs. 23.3%, P = 0.02) were significantly fewer in the online group than in the offline group. The proportion of INR values in the therapeutic range (53.8% vs. 40.1%, P < 0.01) was significantly higher in the online group. Warfarin management using the Alfalfa app appears to be a safe and effective method for warfarin management when patients cannot physically visit hospitals for follow-up. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11239-021-02630-0. Springer US 2022-01-29 2022 /pmc/articles/PMC8799972/ /pubmed/35092566 http://dx.doi.org/10.1007/s11239-021-02630-0 Text en © The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2022 This article is made available via the PMC Open Access Subset for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.
spellingShingle Article
Jiang, Shaojun
Lv, Meina
Zeng, Zhiwei
Fang, Zongwei
Chen, Mingrong
Qian, Jiafen
Wu, Tingting
Chen, Wenjun
Zhang, Jinhua
Efficacy and safety of app-based remote warfarin management during COVID-19-related lockdown: a retrospective cohort study
title Efficacy and safety of app-based remote warfarin management during COVID-19-related lockdown: a retrospective cohort study
title_full Efficacy and safety of app-based remote warfarin management during COVID-19-related lockdown: a retrospective cohort study
title_fullStr Efficacy and safety of app-based remote warfarin management during COVID-19-related lockdown: a retrospective cohort study
title_full_unstemmed Efficacy and safety of app-based remote warfarin management during COVID-19-related lockdown: a retrospective cohort study
title_short Efficacy and safety of app-based remote warfarin management during COVID-19-related lockdown: a retrospective cohort study
title_sort efficacy and safety of app-based remote warfarin management during covid-19-related lockdown: a retrospective cohort study
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8799972/
https://www.ncbi.nlm.nih.gov/pubmed/35092566
http://dx.doi.org/10.1007/s11239-021-02630-0
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