Display Settings:

Format

Send to:

Choose Destination
See comment in PubMed Commons below
BMJ. 1997 Apr 26;314(7089):1252-6.

Evaluation of a decision support system for initiation and control of oral anticoagulation in a randomised trial.

Author information

  • 1Cardiovascular Department, Whittington Hospital, London.

Abstract

OBJECTIVE:

To determine whether a computerised decision support system for initiation and control of oral anticoagulant treatment improves quality of anticoagulant control achieved by trainee doctors.

DESIGN:

Randomised controlled trial.

SETTING:

District general hospital in North London.

SUBJECTS:

148 inpatients requiring start of warfarin treatment.

INTERVENTIONS:

Management by trainee doctors (to achieve therapeutic range of international normalised ratio of 2 to 3) with indirect assistance from computerised decision support system (intervention group) or without such assistance (control group).

MAIN OUTCOME MEASURES:

Median time to therapeutic range, stable dose, and first pseudoevent (excessive international normalised ratio after therapeutic range has been reached) and person time spent in the therapeutic range.

RESULTS:

72 patients were randomised to the intervention group and 76 to control group. Median time to reach international normalised ratio of > or = 2 was not significantly different in the two groups (3 days). Median time to achieve a stable dose was significantly lower in intervention group than in controls (7 days v 9 days, P = 0.01) without excessive overtreatment or undertreatment with anticoagulant. Patients in intervention group spent greater proportion of time in therapeutic range, both as inpatients (59% v 52%) and outpatients (64% v 51%).

CONCLUSION:

The computerised decision support system was safe and effective and improved the quality of initiation and control of warfarin treatment by trainee doctors.

PMID:
9154031
[PubMed - indexed for MEDLINE]
PMCID:
PMC2126598
Free PMC Article
PubMed Commons home

PubMed Commons

0 comments
How to join PubMed Commons

    Supplemental Content

    Icon for HighWire Icon for PubMed Central
    Loading ...
    Write to the Help Desk