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  • A nurse led clinic and computer decision support system for anticoagulation decisions was at least as effective as a hospital clinic

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A nurse led clinic and computer decision support system for anticoagulation decisions was at least as effective as a hospital clinic

https://doi.org/10.1136/ebn.4.2.57

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    Fitzmaurice DA, Hobbs FD, Murray ET, et al.Oral anticoagulation management in primary care with the use of computerized decision support and near-patient testing: a randomized, controlled trial.Arch Intern Med2000 Aug 14-28;160:2343–8OpenUrlCrossRefPubMedWeb of Science

    QUESTION: For patients who require oral anticoagulation, is a nurse led clinic that uses onsite blood testing and a computerised decision support system as effective as routine hospital care for maintaining appropriate international normalised ratios (INRs)?

    Design

    Randomised {allocation concealed}*, unblinded, controlled trial with 1 year of follow up.

    Setting

    9 of 21 potential general practices in Birmingham, UK.

    Patients

    224 adults (55% men) who were receiving warfarin. Follow up was 82%.

    Intervention

    122 patients were allocated to nurse led care in the general practice. The nurse met with the patient, measured the INR with onsite equipment, and used the computer program (Anticoagulation Management Support System [Softop Information Systems, Warwick, UK]) to direct dosing decisions. The program was …

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