Primary care management of patients with non-valvular atrial fibrillation who are uncontrolled on warfarin

Development Group: Fay, Assomull, Derry & Price
This management algorithm was developed by a multidisciplinary expert panel: Fay M et al with the support of a grant from Bayer.

Assessment of patients on warfarin therapy

  • When assessing the quality and safety of warfarin therapy, the wishes of the patient should be taken into account. Options for anticoagulation should be discussed with the patient and the choice based on their clinical features and preferences
  • Good anticoagulation control is indicated by: 
    • TTR >65% and no INR values >5 or <1.5
  • Poor anticoagulation control is indicated by any of the following:
    • TTR <65%
    • two unexplained INR values >5 or one unexplained INR value >8 within past 6 months
    • two unexplained INR values <1.5 within past 6 months

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