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  • A nurse led clinic and computer decision support software for anticoagulation decisions were as effective as a hospital clinic

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A nurse led clinic and computer decision support software for anticoagulation decisions were as effective as a hospital clinic

https://doi.org/10.1136/ebm.6.2.61

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    (2000) Arch Intern Med 160, 2343. 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.. Aug 14/28;. :. –8.
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 QUESTION: For patients who require oral anticoagulation, is a primary care, nurse led clinic that uses on site testing and computerised decision support software more effective than routine hospital care for maintaining appropriate international normalised ratios (INRs)?

    Design

    Randomised (unclear allocation concealment*), unblinded,* controlled trial, stratified by practice size, with 1 year follow up.

    Setting

    12 of 21 potential general practices and 3 hospital clinics in Birmingham, UK.

    Patients

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

    Intervention

    122 patients were allocated to nurse led management in a primary care setting. The nurse met with the patient, measured the INR with on site equipment, and used the computer program (Anticoagulation Management Support System [Softop Information Systems, Warwick, England, UK]) to direct dosing decisions. The program was based on the British Society of Haematology …

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    Footnotes

    • Sources of funding: UK Medical Research Council Reaching Our Potential Award scheme and UK National Health Service Research and Development Primary and Secondary Care Interface Programme.

    • For correspondence: Dr D A Fitzmaurice, Department of General Practice, Medical School, University of Birmingham, Birmingham B15 2TT, UK. Fax +44 (0)121 414 3759.

    • A modified version of this abstract also appears in Evidence-Based Nursing.

    • ↵* See glossary.