Algorithms for monitoring warfarin use: Results from Delphi Method
Summary Warfarin stands as the most prescribed oral anticoagulant. New oral anticoagulants have been approved recently; however, their use is limited and the reversibility techniques of the anticoagulation effect are little known. Thus, our study’s purpose was to develop algorithms for therapeutic monitoring of patients taking warfarin based on the opinion of physicians who prescribe this medicine in their clinical practice. The development of the algorithm was performed in two stages, namely: (i) literature review and (ii) algorithm evaluation by physicians using a Delphi Method. Based on the articles analyzed, two algorithms were developed: “Recommendations for the use of warfarin in anticoagulation therapy” and “Recommendations for the use of warfarin in anticoagulation therapy: dose adjustment and bleeding control.” Later, these algorithms were analyzed by 19 medical doctors that responded to the invitation and agreed to participate in the study. Of these, 16 responded to the first round, 11 to the second and eight to the third round. A 70% consensus or higher was reached for most issues and at least 50% for six questions. We were able to develop algorithms to monitor the use of warfarin by physicians using a Delphi Method. The proposed method is inexpensive and involves the participation of specialists, and it has proved adequate for the intended purpose. Further studies are needed to validate these algorithms, enabling them to be used in clinical practice.
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Associação Médica Brasileira
2017
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oai:scielo:S0104-423020170010008422017-12-11Algorithms for monitoring warfarin use: Results from Delphi MethodKano,Eunice KazueBorges,Jessica BassaniScomparini,Erika BurimCuri,Ana PaulaRibeiro,Eliane Delphi technique warfarin decision-making medication therapy management Summary Warfarin stands as the most prescribed oral anticoagulant. New oral anticoagulants have been approved recently; however, their use is limited and the reversibility techniques of the anticoagulation effect are little known. Thus, our study’s purpose was to develop algorithms for therapeutic monitoring of patients taking warfarin based on the opinion of physicians who prescribe this medicine in their clinical practice. The development of the algorithm was performed in two stages, namely: (i) literature review and (ii) algorithm evaluation by physicians using a Delphi Method. Based on the articles analyzed, two algorithms were developed: “Recommendations for the use of warfarin in anticoagulation therapy” and “Recommendations for the use of warfarin in anticoagulation therapy: dose adjustment and bleeding control.” Later, these algorithms were analyzed by 19 medical doctors that responded to the invitation and agreed to participate in the study. Of these, 16 responded to the first round, 11 to the second and eight to the third round. A 70% consensus or higher was reached for most issues and at least 50% for six questions. We were able to develop algorithms to monitor the use of warfarin by physicians using a Delphi Method. The proposed method is inexpensive and involves the participation of specialists, and it has proved adequate for the intended purpose. Further studies are needed to validate these algorithms, enabling them to be used in clinical practice.info:eu-repo/semantics/openAccessAssociação Médica BrasileiraRevista da Associação Médica Brasileira v.63 n.10 20172017-10-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0104-42302017001000842en10.1590/1806-9282.63.10.842 |
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Kano,Eunice Kazue Borges,Jessica Bassani Scomparini,Erika Burim Curi,Ana Paula Ribeiro,Eliane |
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Kano,Eunice Kazue Borges,Jessica Bassani Scomparini,Erika Burim Curi,Ana Paula Ribeiro,Eliane Algorithms for monitoring warfarin use: Results from Delphi Method |
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Kano,Eunice Kazue Borges,Jessica Bassani Scomparini,Erika Burim Curi,Ana Paula Ribeiro,Eliane |
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Kano,Eunice Kazue |
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Algorithms for monitoring warfarin use: Results from Delphi Method |
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Algorithms for monitoring warfarin use: Results from Delphi Method |
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Algorithms for monitoring warfarin use: Results from Delphi Method |
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Algorithms for monitoring warfarin use: Results from Delphi Method |
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Algorithms for monitoring warfarin use: Results from Delphi Method |
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algorithms for monitoring warfarin use: results from delphi method |
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Summary Warfarin stands as the most prescribed oral anticoagulant. New oral anticoagulants have been approved recently; however, their use is limited and the reversibility techniques of the anticoagulation effect are little known. Thus, our study’s purpose was to develop algorithms for therapeutic monitoring of patients taking warfarin based on the opinion of physicians who prescribe this medicine in their clinical practice. The development of the algorithm was performed in two stages, namely: (i) literature review and (ii) algorithm evaluation by physicians using a Delphi Method. Based on the articles analyzed, two algorithms were developed: “Recommendations for the use of warfarin in anticoagulation therapy” and “Recommendations for the use of warfarin in anticoagulation therapy: dose adjustment and bleeding control.” Later, these algorithms were analyzed by 19 medical doctors that responded to the invitation and agreed to participate in the study. Of these, 16 responded to the first round, 11 to the second and eight to the third round. A 70% consensus or higher was reached for most issues and at least 50% for six questions. We were able to develop algorithms to monitor the use of warfarin by physicians using a Delphi Method. The proposed method is inexpensive and involves the participation of specialists, and it has proved adequate for the intended purpose. Further studies are needed to validate these algorithms, enabling them to be used in clinical practice. |
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Associação Médica Brasileira |
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2017 |
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http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0104-42302017001000842 |
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