| الوصف: |
Nahusenay Masresha,1 Esileman Abdela Muche,2 Asmamaw Atnafu,3 Ousman Abdela2 1Hospital Pharmacy, University of Gondar Comprehensive and Specialized Hospital, Gondar, Ethiopia; 2Department of Clinical Pharmacy, School of Pharmacy, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 3Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, EthiopiaCorrespondence: Ousman Abdela Tel +251-912-02-3692Fax +251-58-114 1240Email ousmy2009@gmail.comPurpose: To assess the quality of warfarin anticoagulation and its clinical outcomes on patients treated with warfarin at the University of Gondar comprehensive specialized hospital, North-west Ethiopia.Methods: We reviewed medical records of patients treated with warfarin between June 1, 2016, and May 30, 2018, at the University of Gondar comprehensive specialized hospital. The quality of anticoagulation was evaluated using the percentage of time spent in the therapeutic range. Data were entered into Statistical Product and Service Solutions (SPSS), version 20. Descriptive statistics were used to describe the socio-demographic and clinical characteristics of study participants. Multivariable logistic regression analysis was performed to identify independent predictors of quality of anticoagulation. Statistical significance was declared when the p-value was less than 0.05 at 95% confidence interval (CI).Results: From a total of 202 patients’ charts reviewed, women accounted for 134 (67.3%). The mean participants’ age was 44.33 years (± 17.05years SD). The median time spent in the therapeutic range was 37.91 with an IQR of (0.00– 65.86). More than two-third (143, (70.8%)) of participants had poor anticoagulation quality (time spent in the therapeutic range is less than 65%). Twenty-seven patients (13.4%) experienced adverse medication events of bleeding and thromboembolic events. Logistic regression analysis showed that potential medication interaction [p= 0.003 95% CI Adjusted odds ratio (AOR): 0.32 (0.152– 0.689)] and presence of co-morbidity [p= 0.037 95% CI AOR: 0.70 (1.046– 4.105)] were significantly associated with quality of anticoagulation.Conclusion: The quality of warfarin anticoagulation at the University of Gondar comprehensive specialized hospital was poor. A strong effort is needed to improve the quality of anticoagulation. Patients who had other co-morbidity conditions and potentially interacting medication need special attention.Keywords: warfarin, anticoagulation, University of Gondar, TTR, Ethiopia |
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