服用华法林患者抗凝治疗现状调查及质量评价

Investigation and Quality Evaluation of Anticoagulant Therapy in Patients Taking Warfarin

目的:对我院服用华法林抗凝治疗患者开展回顾性分析,评价其抗凝治疗质量,为探索提高华法林抗凝质量的连续性药学服务工作模式提供参考。方法:收集2015年1月~2018年12月在我院服用华法林并定期监测国际标准化比值(INR)的患者,根据纳入与排除标准筛选入组患者,调查其抗凝现状,采用线性内插法计算INR在治疗范围内的时间百分比(TTR),对结果进行统计分析。结果:华法林用量呈逐年增长趋势,服用华法林进行抗凝治疗的患者数亦逐年增加。患者就诊科室中,心血管内科所占比例最大,为59.76%;患者数最多的抗凝适应证为心房颤动,其次包括心脏瓣膜置换、静脉栓塞、肺栓塞等。患者TTR的总体平均值为(66.27±16.35)%;2015年TTR>70%的患者占比为42.03%,2016年为43.36%,2017年为47.01%,2018年为56.55%。结论:我院患者服用华法林治疗质量可以接受,INR达标率逐年增高,积极开展连续性药学服务具有重要意义。

Objective:To analysis the retrospective data of patients with warfarin anticoagulant therapy in our hospital, evaluate the quality of anticoagulant therapy in patients taking warfarin, explore a working model that provides continuous pharmaceutical services for warfarin anticoagulant patients, and improve the anticoagulant effect. Methods:Collecting patients’ information who took warfarin in our hospital from January 2015 to December 2018 and regularly monitored the INR values through information system, screening for enrollable patients based on inclusion and exclusion criteria, investigation and quality evaluation of anticoagulant therapy in those patients. Results:Warfarin dosage has been increasing year by year, and the number of patients taking warfarin for anticoagulation has also increased year by year. Among the department patients visited, the cardiovascular department accounted for the largest proportion, which was 59.76%. Warfarin was mainly used for patients with fibrillation, and heart valve replacement, vein thromboembolism, pulmonary embolism and so on. The average TTR calculated by the frequency in therapeutic range for all patients was(66.27±16.35) %. The number of patients with TTR >70%(the best quality of anticoagulant therapy) in 2015 accounted for 42.03%, 43.36% in 2016, 47.01% in 2017, and 56.55% in 2018. Conclusion:The quality of warfarin treatment in our hospital is acceptable, and the rate of INR compliance has increased year by year. It’s of great significance to actively carry out the continuous pharmaceutical services.