International normalised ratio control in a non-metropolitan setting in Western Cape Province, South Africa
| dc.contributor.advisor | Ntsekhe, Mpiko | |
| dc.contributor.advisor | Gould, T J | |
| dc.contributor.author | Prinsloo, Dawid Nicolaas | |
| dc.date.accessioned | 2022-03-10T14:05:17Z | |
| dc.date.available | 2022-03-10T14:05:17Z | |
| dc.date.issued | 2021 | |
| dc.date.updated | 2022-03-10T14:04:47Z | |
| dc.description.abstract | Background: The quality of INR control determines the effectiveness and safety of Warfarin. Data on INR control in non-metropolitan settings of South Africa (SA) is sparse. Objectives: To examine the Time in Therapeutic Range (TTR) and its potential predictors in a sample of Garden Route District Municipality INR clinics Methods: INR records from eight Primary Healthcare Clinics (PHCs) were reviewed. The TTR and percentage of patients with a TTR greater than 65% were determined. A host of variables were analysed for association with TTR. Results: The median age of the cohort of 191 was 56 years (IQR 44-69). The median TTR was 37.17% (IQR 20.21-58.78); only 17.8% of patients had a TTR > 65%. Compared to patients older than 50, those under 50 had worse INR control (TTR 26.63%, IQR 16.05-52.98 vs. 43.5%, IQR 23.52- 60.08, p=0.01). Patients hospitalised for any reason during the study period had worse INR control than patients not hospitalised (TTR 26.23%, IQR 16.24-50.16 vs. 42.89, IQR 23.5-61.95, p=0.02). On multivariable regression analysis, participants on warfarin for atrial fibrillation/flutter had better INR control (OR 2.21, CI 1.02-4.77, p=0.04) but the control was still very poor. Conclusion: INR control as determined by TTR and proportion of TTR >65% in these non-metropolitan clinics was poor. Age and markers of illness predicted poor control. There was a difference in control between groups depending on the indication for warfarin. Evidence-based measures to improve the quality of INR control amongst patients on warfarin therapy need to be instituted as a matter of urgency. | |
| dc.identifier.apacitation | Prinsloo, D. N. (2021). <i>International normalised ratio control in a non-metropolitan setting in Western Cape Province, South Africa</i>. (). ,Faculty of Health Sciences ,Department of Medicine. Retrieved from http://hdl.handle.net/11427/36043 | en_ZA |
| dc.identifier.chicagocitation | Prinsloo, Dawid Nicolaas. <i>"International normalised ratio control in a non-metropolitan setting in Western Cape Province, South Africa."</i> ., ,Faculty of Health Sciences ,Department of Medicine, 2021. http://hdl.handle.net/11427/36043 | en_ZA |
| dc.identifier.citation | Prinsloo, D.N. 2021. International normalised ratio control in a non-metropolitan setting in Western Cape Province, South Africa. . ,Faculty of Health Sciences ,Department of Medicine. http://hdl.handle.net/11427/36043 | en_ZA |
| dc.identifier.ris | TY - Master Thesis AU - Prinsloo, Dawid Nicolaas AB - Background: The quality of INR control determines the effectiveness and safety of Warfarin. Data on INR control in non-metropolitan settings of South Africa (SA) is sparse. Objectives: To examine the Time in Therapeutic Range (TTR) and its potential predictors in a sample of Garden Route District Municipality INR clinics Methods: INR records from eight Primary Healthcare Clinics (PHCs) were reviewed. The TTR and percentage of patients with a TTR greater than 65% were determined. A host of variables were analysed for association with TTR. Results: The median age of the cohort of 191 was 56 years (IQR 44-69). The median TTR was 37.17% (IQR 20.21-58.78); only 17.8% of patients had a TTR > 65%. Compared to patients older than 50, those under 50 had worse INR control (TTR 26.63%, IQR 16.05-52.98 vs. 43.5%, IQR 23.52- 60.08, p=0.01). Patients hospitalised for any reason during the study period had worse INR control than patients not hospitalised (TTR 26.23%, IQR 16.24-50.16 vs. 42.89, IQR 23.5-61.95, p=0.02). On multivariable regression analysis, participants on warfarin for atrial fibrillation/flutter had better INR control (OR 2.21, CI 1.02-4.77, p=0.04) but the control was still very poor. Conclusion: INR control as determined by TTR and proportion of TTR >65% in these non-metropolitan clinics was poor. Age and markers of illness predicted poor control. There was a difference in control between groups depending on the indication for warfarin. Evidence-based measures to improve the quality of INR control amongst patients on warfarin therapy need to be instituted as a matter of urgency. DA - 2021 DB - OpenUCT DP - University of Cape Town KW - Medicine LK - https://open.uct.ac.za PY - 2021 T1 - International normalised ratio control in a non-metropolitan setting in Western Cape Province, South Africa TI - International normalised ratio control in a non-metropolitan setting in Western Cape Province, South Africa UR - http://hdl.handle.net/11427/36043 ER - | en_ZA |
| dc.identifier.uri | http://hdl.handle.net/11427/36043 | |
| dc.identifier.vancouvercitation | Prinsloo DN. International normalised ratio control in a non-metropolitan setting in Western Cape Province, South Africa. []. ,Faculty of Health Sciences ,Department of Medicine, 2021 [cited yyyy month dd]. Available from: http://hdl.handle.net/11427/36043 | en_ZA |
| dc.language.rfc3066 | eng | |
| dc.publisher.department | Department of Medicine | |
| dc.publisher.faculty | Faculty of Health Sciences | |
| dc.subject | Medicine | |
| dc.title | International normalised ratio control in a non-metropolitan setting in Western Cape Province, South Africa | |
| dc.type | Master Thesis | |
| dc.type.qualificationlevel | Masters | |
| dc.type.qualificationlevel | MMed |