EVALUATION OF WARFARIN ANTICOAGULATION AND ITS CLINICAL OUTCOME IN UNIVERSITY OF GONDAR COMPRENSIVE SPECIALIZED HOSPITAL NORTH-WEST ETHIOPIA: A CROSS-SECTIONAL STUDY.

Abstract

ABSTRACT Background: Warfarin therapy is the basis for prevention and treatment of thromboembolic disease; however, initiation of warfarin therapy is challenging because it has been associated with plenty of problems such as bleeding risk, interaction with various drugs and diet. Objective: To evaluate the quality of anticoagulation and clinical outcome of patients on warfarin therapy at University of Gondar comprehensive specialized hospital. Method: A retrospective cross-sectional study design which analyzed data for eligible participants treated between June 2016 and June 2018 was carried out at University of Gondar comprehensive specialized hospital Ethiopia. Two hundred two files of adult patients on warfarin anticoagulation who met the study inclusion criteria were reviewed. The percentage of time spent in therapeutic range was calculated by Rosendaal Linear Interpolation method. The data was analyzed by SPSS version 20.0. Multivariate binary logistic regression was used to identify independent predictors of poor anticoagulation control. Statistical significance was determined at 95% confidence interval and p-value 0.05. Result: A total of 202 patients were included in this study and the mean age of participants was 44.33 years percentage of TTR was 41% with SD ±35.46%. Twenty seven patients experienced adverse drug events; from these 9 patients Conclusion: Quality of warfarin anticoagulation for various indications receiving medical care in UoGCSH was poor so that strong effort is needed to improve the level of anticoagulation control. Co-morbidity and potential drug interaction needs special attention. Keyword: warfarin, quality of anticoagulation, UoGCSH, TTR.