22. Miscellanea: 22.8 Quality Assessment of Oral Anticoagulation in Patients with AF

Abstract

Objective

In Belgium oral anticoagulation therapy is mainly supervised by general practitioners (gps). The aim of the study is to evaluate the quality of management of oral anticoagulation by gps in patients with atrial fibrillation.

Methods

In a retrospective cross-sectional study, involving 66 GP-practices, the INR-values obtained over a 6 month period were analysed.

Results

395 patients were included in the study with a mean age of 74 years (+/− 9.6). 3,111 INR-values were obtained. The mean number of tests/month per patient was 2.75 (+/−4.3). A total of 49,728 days of therapy was evaluated. 53% of the day values were within 0.5 INR-units from target (and 69% within 0.75 INR-units from target). The incidence rate for major bleeding was 4.4/100 patient years (and 2.9/100 patient years for thrombo-embolic events). There is a significant relation between the patient performance and the presence of an event (p = 0.017). The odds ratio for the patient performance and an event is 2.85 (95% CI 1.29 to 6.33).

Conclusion

The quality of management of oral anticoagulation by the gps in Belgium is suboptimal.