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JOURNAL ARTICLE
MULTICENTER STUDY
RESEARCH SUPPORT, NON-U.S. GOV'T
Quality of clinical documentation and anticoagulation control in patients with chronic nonvalvular atrial fibrillation in routine medical care.
American Journal of Medical Quality : the Official Journal of the American College of Medical Quality 2007 September
OBJECTIVE: Anticoagulation quality and record documentation were retrospectively assessed in patients with chronic nonvalvular atrial fibrillation (CNVAF) managed in a routine care setting.
METHODS: Medical record data extraction from physician practices in 4 regions of the United States.
RESULTS: Of 686 patients, 59% had an electrocardiogram confirming CNVAF, 84% listed at least 1 stroke risk factor, and 60% indicated the goal target international normalized ratio (INR). Two thirds of INRs>3.0 or <2.0 had no recorded dose change, nor did 45% of INRs>5.0. Vitamin K was given (3%) or anticoagulation was temporarily discontinued (9%) for INRs>5.0. The median interval of INR testing was 21 days, which decreased to 7 days for INRs> 4.60. Patients spent 58% of the time in therapeutic range.
CONCLUSION: Serious deficiencies in quality and documentation of routine medical care of anticoagulation for patients with CNVAF continue to exist.
METHODS: Medical record data extraction from physician practices in 4 regions of the United States.
RESULTS: Of 686 patients, 59% had an electrocardiogram confirming CNVAF, 84% listed at least 1 stroke risk factor, and 60% indicated the goal target international normalized ratio (INR). Two thirds of INRs>3.0 or <2.0 had no recorded dose change, nor did 45% of INRs>5.0. Vitamin K was given (3%) or anticoagulation was temporarily discontinued (9%) for INRs>5.0. The median interval of INR testing was 21 days, which decreased to 7 days for INRs> 4.60. Patients spent 58% of the time in therapeutic range.
CONCLUSION: Serious deficiencies in quality and documentation of routine medical care of anticoagulation for patients with CNVAF continue to exist.
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