Using E-Management to Improve Oral Anticoagulation Tx
An internet-based health management program may help reduce adverse events.
HealthDay News -- Electronic-health-based management of oral anticoagulation (OAC) therapy is associated with fewer adverse events, according to a study published in the Journal of Thrombosis and Haemostasis.
Jürgen H. Prochaska, MD, from the University Medical Center Mainz in Germany, and colleagues conducted a prospective multicenter cohort study to compare the clinical outcome of OAC patients managed by an e-health-based coagulation service (CS; 760 individuals) vs regular medical care (RMC; 1,558 individuals).
The researchers found that the primary study end point (composite of thromboembolism, clinically-relevant bleeding, and death) occurred in 15.7 and 7.0 per 100 patient-years in RMC and CS (rate ratio [RR] 2.3; 95% CI, 1.7 to 3.1). RMC correlated with higher rates for major and clinically-relevant bleeding than CS (6.8 vs 2.6 and 10.1 vs 3.6 per 100 patient-years, respectively). Comparing RMC and CS, the RR for thromboembolic events was 1.5 (95% CI, 0.8 to 2.6). RMC correlated with higher frequency of hospitalization (RR, 2.6; 95% CI, 2.3 to 3.0) and all-cause mortality (RR, 4.6; 95% CI, 2.8 to 7.7). After adjustment for confounding variables, the hazard ratios significantly favored CS treatment for the primary end point, clinically-relevant bleeding, hospitalization, and all-cause mortality.
"In this study, e-health based management of OAC therapy was associated with a lower frequency of OAC-specific and non-specific adverse events," the authors wrote.
Prochaska JH, Göbel S, Keller K, et al. e-Health based management of patients receiving oral anticoagulation therapy: results from the observational thrombEVAL study [published online April 27, 2017]. J Thromb Haemost. doi:10.1111/jth.13727