Anticoagulation clinics and patient self-testing for patients on chronic warfarin therapy: A cost-effectiveness analysis.

Abstract:

:This study was intended to evaluate the cost-effectiveness of anticoagulation clinic care and self-testing for the management of patients on chronic warfarin therapy. Using a 5-year Markov model, we evaluated the health and economic outcomes associated with each of three different anticoagulation management approaches: (1) usual care, (2) anticoagulation clinic testing with a capillary monitor, and (3) patient self-testing with a capillary monitor. Data available in the published literature and data from a large health system were used to develop model assumptions. Model results indicate that over a 5-year period, compared with usual care, anticoagulation clinic testing results in a total of 1.7 fewer thromboembolic events and 2.0 less hemorrhagic events per 100 patients. Another 4.0 thromboembolic events and 0.8 hemorrhagic events are avoided with patient self-testing compared with anticoagulation clinic testing. In addition to the health advantages of these strategies, both also have cost advantages. When the costs incurred by provider organizations and patients are considered, patient self-testing is the most cost-effective alternative, resulting in an overall cost saving.

journal_name

J Thromb Thrombolysis

authors

Lafata JE,Martin SA,Kaatz S,Ward RE

doi

10.1023/a:1018704318655

subject

Has Abstract

pub_date

2000-06-01 00:00:00

pages

S13-9

eissn

0929-5305

issn

1573-742X

journal_volume

9 Suppl 1

pub_type

杂志文章
  • Primary angioplasty in acute myocardial infarction: does age or race matter?

    abstract:PURPOSE:Recent data suggest substantial variations in the treatment of acute myocardial infarction based on age, race, gender and socioeconomic status. We evaluated the use of primary angioplasty (PA) in acute myocardial infarction (AMI) in elderly and minority patients treated at an urban, teaching hospital. SUBJECTS...

    journal_title:Journal of thrombosis and thrombolysis

    pub_type: 杂志文章

    doi:10.1023/b:thro.0000003326.00180.60

    authors: Regueiro CR,Gill N,Hart A,Crawshaw L,Hentosz T,Shannon RP

    更新日期:2003-04-01 00:00:00

  • Guidance for the prevention and treatment of cancer-associated venous thromboembolism.

    abstract::Venous thromboembolism (VTE) is a highly prevalent complication of malignancy with emerging changes in incidence, diagnosis and treatment paradigms. This manuscript, initiated by the Anticoagulation Forum, provides clinical guidance based on existing guidelines and consensus expert opinion where guidelines are lacking...

    journal_title:Journal of thrombosis and thrombolysis

    pub_type: 杂志文章,评审

    doi:10.1007/s11239-015-1313-4

    authors: Khorana AA,Carrier M,Garcia DA,Lee AY

    更新日期:2016-01-01 00:00:00

  • Clinical validation of immunoassay HemosIL® AcuStar HIT-IgG (PF4-H) in the diagnosis of Heparin-induced thrombocytopenia.

    abstract::Heparin induced thrombocytopenia (HIT) is a life and limb-threatening complication of heparin exposure. The misdiagnosis of this disease can have major consequences on the patients. The objective of this study was to evaluate a diagnostic strategy that combines the 4Ts score with the result of HemosIL® AcuStar HIT-IgG...

    journal_title:Journal of thrombosis and thrombolysis

    pub_type: 杂志文章

    doi:10.1007/s11239-020-02349-4

    authors: Marashi-Sabouni Z,Vayne C,Ibrahim-Kosta M,Guidon C,Loundou A,Guery EA,Morange PE,Camoin-Jau L

    更新日期:2021-01-01 00:00:00

  • Determination of non-Vitamin K oral anticoagulant (NOAC) effects using a new-generation thrombelastography TEG 6s system.

    abstract::Non vitamin K oral anticoagulants (NOACs) do not require regular monitoring but information about their pharmacodynamic effect may be importantin situations like trauma, stroke oremergent surgery. Currently, no standardized point-of-care test is available to evaluate the anticoagulant effects of NOACs. We evaluated th...

    journal_title:Journal of thrombosis and thrombolysis

    pub_type: 杂志文章

    doi:10.1007/s11239-017-1477-1

    authors: Bliden KP,Chaudhary R,Mohammed N,Muresan AA,Lopez-Espina CG,Cohen E,Raviv G,Doubleday M,Zaman F,Mathew B,Tantry US,Gurbel PA

    更新日期:2017-05-01 00:00:00

  • Impact of primary PCI volume on hospital mortality in STEMI patients: does time-to-presentation matter?

    abstract::The exact relationship between primary percutaneous coronary intervention (PCI) volume and mortality remains unclear. No data are available on how this relationship could be affected by time-to-presentation. The primary aim of this study was to evaluate the impact of hospital primary PCI volume on in-hospital mortalit...

    journal_title:Journal of thrombosis and thrombolysis

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1007/s11239-011-0598-1

    authors: Navarese EP,De Servi S,Politi A,Martinoni A,Musumeci G,Boschetti E,Belli G,D'Urbano M,Piccaluga E,Lettieri C,Klugmann S

    更新日期:2011-08-01 00:00:00

  • Relationship between the heparin management test and the HemoTec activated clotting time in patients undergoing percutaneous coronary intervention.

    abstract::Point-of-care whole blood coagulation tests are critical in the management of patients who undergo percutaneous coronary intervention. The Hemochron and HemoTec devices have been traditionally used to measure the activated clotting time (ACT) in the cardiac catheterization laboratory. The heparin management test (HMT)...

    journal_title:Journal of thrombosis and thrombolysis

    pub_type: 杂志文章

    doi:10.1023/a:1011908803939

    authors: Tsimikas S,Beyer R,Hassankhani A

    更新日期:2001-05-01 00:00:00

  • Influence of chronic kidney disease on anticoagulation levels and bleeding after primary percutaneous coronary intervention in patients treated with unfractionated heparin.

    abstract::Unfractionated heparin (UFH) plasma protein binding and elimination might be impaired in patients with chronic kidney disease (CKD-defined as creatinine clearance <60 ml/min). It is currently unknown at which UFH bolus dose persistent prolongation of activated partial thromboplastin time (aPTT) occurs in ST-segment el...

    journal_title:Journal of thrombosis and thrombolysis

    pub_type: 临床试验,杂志文章

    doi:10.1007/s11239-015-1255-x

    authors: Kikkert WJ,van Brussel PM,Damman P,Claessen BE,van Straalen JP,Vis MM,Baan J Jr,Koch KT,Peters RJ,de Winter RJ,Piek JJ,Tijssen JG,Henriques JP

    更新日期:2016-04-01 00:00:00

  • Are surgical patients at risk of venous thromboembolism currently meeting the Surgical Care Improvement Project performance measure for appropriate and timely prophylaxis?

    abstract::The US Surgical Care Improvement Project (SCIP) has approved two performance measures to improve venous thromboembolism (VTE) prevention. SCIP-VTE-2 measures the proportion of surgery patients who received appropriate VTE prophylaxis within 24 h prior to surgery to 24 h after surgery. This study assesses the current r...

    journal_title:Journal of thrombosis and thrombolysis

    pub_type: 杂志文章

    doi:10.1007/s11239-009-0393-4

    authors: Deitelzweig SB,Lin J,Hussein M,Battleman D

    更新日期:2010-07-01 00:00:00

  • Effect of taurine on endotoxin-induced alterations in plasma asymmetric dimethylarginine, L-arginine and nitric oxide in guinea pigs.

    abstract::The effect of taurine on the plasma levels of L-arginine, asymmetrical dimethylarginine (ADMA) and L-arginine/ADMA ratio and nitric oxide was investigated in experimental endotoxemia. L-arginine and ADMA levels were quantified by high performance liquid chromatography with fluorescence detector. Nitric oxide level was...

    journal_title:Journal of thrombosis and thrombolysis

    pub_type: 杂志文章

    doi:10.1007/s11239-007-0011-2

    authors: Balabanli B,Erdamar H,Türközkan N,Yaman H,Kurt Y

    更新日期:2007-08-01 00:00:00

  • Renal Vein Thrombosis and Selective Arterial or Venous Thrombolytic Therapy.

    abstract::Background: Renal vein thrombosis (RVT) complicating the nephrotic syndrome is associated with a poor prognosis. Methods/Results: RVT was diagnosed in 12 of 60 patients with a diagnosis of nephrotic syndrome suggested by computed tomography (CT) and subsequently confirmed by selective renal angiography. Fifty patients...

    journal_title:Journal of thrombosis and thrombolysis

    pub_type: 杂志文章

    doi:10.1007/BF00226414

    authors: Wu ZL,Zhou KR,Liao Lt

    更新日期:1996-01-01 00:00:00

  • Structure-function relationships of factor Xa inhibitors: implications for the practicing clinician.

    abstract::The recent development and approval of novel oral anticoagulants represents a significant success in the intelligent design of target-specific therapeutics. However, while these agents obviate many of the shortcomings of their predecessor (warfarin), they present novel challenges in pharmacologic management as well. E...

    journal_title:Journal of thrombosis and thrombolysis

    pub_type: 杂志文章,评审

    doi:10.1007/s11239-013-0991-z

    authors: Steinberg BA,Becker RC

    更新日期:2014-01-01 00:00:00

  • Platelet response to direct thrombin inhibitor or fondaparinux treatment in patients with suspected heparin-induced thrombocytopenia.

    abstract::Making a definitive diagnosis of heparin-induced thrombocytopenia (HIT) can be problematic. A prompt platelet rise following treatment has been proposed as a "post-test" criterion for diagnosis. However, the platelet response following discontinuation of heparin and initiation of a recommended alternative anticoagulan...

    journal_title:Journal of thrombosis and thrombolysis

    pub_type: 杂志文章,多中心研究

    doi:10.1007/s11239-018-1646-x

    authors: Pon TK,Mahajan A,Rosenberg A,Amin A,Shah D,Jenkins I,Gupta V,Hofmann H,Bejjani A,White R

    更新日期:2018-05-01 00:00:00

  • Differing coagulation profiles of patients with monoclonal gammopathy of undetermined significance and multiple myeloma.

    abstract::The link between myeloma and thrombosis is well established. Monoclonal gammopathy of undetermined significance (MGUS) has also been associated with an increased risk of thrombosis. It was recently demonstrated that patients with myeloma display changes in thromboelastometry that may indicate a prothrombotic state. Th...

    journal_title:Journal of thrombosis and thrombolysis

    pub_type: 杂志文章

    doi:10.1007/s11239-014-1140-z

    authors: Crowley MP,Quinn S,Coleman E,Eustace JA,Gilligan OM,O'Shea SI

    更新日期:2015-02-01 00:00:00

  • Prospective Comparison of Patient Characteristics and Outcome of Non-prior Aspirin Users versus Aspirin Users with Unstable Angina or Non-Q-Wave Myocardial Infarction Treated with Combination Antithrombotic Therapy.

    abstract::The objective of this study was to determine if aspirin users presenting with acute coronary syndromes are at higher risk for subsequent clinical events. In a trial evaluating combination antithrombotic therapy in resting angina or non-Q-wave myocardial infarction (MI), patients were prospectively dichotomized on admi...

    journal_title:Journal of thrombosis and thrombolysis

    pub_type: 杂志文章

    doi:10.1023/a:1008855220129

    authors: Cohen M,Adams PC,McBride R,Blanke H,Fuster V V

    更新日期:1997-01-01 00:00:00

  • An analysis of mechanisms underlying the antifibrinolytic properties of radiographic contrast agents.

    abstract:BACKGROUND:Radiographic contrast agents inhibit fibrinolysis, although by poorly defined pathways. The purpose of this study was to define specific mechanisms by which contrast agents inhibit clot lysis. METHODS AND RESULTS:Diatrizoate (high osmolar ionic agent), ioxaglate (low osmolar ionic), and ioversol (nonionic) ...

    journal_title:Journal of thrombosis and thrombolysis

    pub_type: 杂志文章

    doi:10.1023/a:1015283210156

    authors: Farrehi PM,Zhu Y,Fay WP

    更新日期:2001-12-01 00:00:00

  • PICC-related upper deep venous thrombosis in patients with hematological malignancies. Management of anticoagulant therapy according to the platelet count.

    abstract::Peripherally inserted central catheters (PICCs) for central venous access are frequently used in patients with hematological malignancies. Their use may be complicated by upper extremity deep venous thrombosis (UEDVT). Additionally, hematological patients are frequently thrombocytopenic and the optimal management of U...

    journal_title:Journal of thrombosis and thrombolysis

    pub_type: 杂志文章

    doi:10.1007/s11239-020-02040-8

    authors: Scamuffa MC,Morano SG,Serrao A,Bruzzese A,Stocchi F,Santoro C,Vozella F,Latagliata R,Chistolini A

    更新日期:2020-04-01 00:00:00

  • Characteristic and prognosis of acute large vessel occlusion in anterior and posterior circulation after endovascular treatment: the ANGEL registry real world experience.

    abstract::There were limited studies comparing the anterior (AC) and posterior (PC) circulation acute ischemic strokes (AIS). Our study aimed to evaluate distinct features of AC and PC strokes regarding clinical, vascular risk, pathogenesis and outcome factors after endovascular procedures. This multicenter prospective study re...

    journal_title:Journal of thrombosis and thrombolysis

    pub_type: 杂志文章

    doi:10.1007/s11239-020-02054-2

    authors: Huo X,Raynald,Gao F,Ma N,Mo D,Sun X,Song L,Jia B,Pan Y,Wang Y,Liu L,Zhao X,Wang Y,Miao Z,ANGEL investigators.

    更新日期:2020-05-01 00:00:00

  • Relationship between biomarkers and subsequent clinical and angiographic restenosis after paclitaxel-eluting stents for treatment of STEMI: a HORIZONS-AMI substudy.

    abstract::Drug-eluting stents (DES) reduce the incidence of in-stent restenosis (ISR) after primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI). Whether the use of biomarkers might be of utility to identify patients who remain at risk for DES ISR after primary PCI has never been exami...

    journal_title:Journal of thrombosis and thrombolysis

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1007/s11239-012-0706-x

    authors: Claessen BE,Stone GW,Mehran R,Witzenbichler B,Brodie BR,Wöhrle J,Witkowski A,Guagliumi G,Zmudka K,Henriques JP,Tijssen JG,Sanidas EA,Chantziara V,Hakim D,Leon S,Xu K,Dangas GD

    更新日期:2012-08-01 00:00:00

  • Fatal warfarin-associated intracranial hemorrhage in atrial fibrillation inpatients.

    abstract::Ischemic stroke and major bleeding, mostly due to intracranial hemorrhage (ICH), cause about the same rates of death in pivotal randomized trials of direct oral anticoagulants (DOACs) versus warfarin for stroke prevention in atrial fibrillation (AF). We analyzed our AF inpatient database to determine whether any ICH-r...

    journal_title:Journal of thrombosis and thrombolysis

    pub_type: 杂志文章

    doi:10.1007/s11239-018-1767-2

    authors: Chopard R,Piazza G,Hurwitz S,Fanikos J,Goldhaber SZ

    更新日期:2019-02-01 00:00:00

  • Acquired thrombotic thrombocytopenic purpura: puzzles, curiosities and conundrums.

    abstract::We report a case of acquired thrombotic thrombocytopenic purpura (TTP) in a 34-year old patient with a prior diagnosis of systemic lupus erythematosis (SLE) who was recently started on hydroxychloroquine. Presenting symptoms included fevers, sore throat and productive cough with progressive weakness, dyspnea on exerti...

    journal_title:Journal of thrombosis and thrombolysis

    pub_type: 杂志文章

    doi:10.1007/s11239-010-0517-x

    authors: Mar N,Mendoza Ladd A

    更新日期:2011-01-01 00:00:00

  • Rivaroxaban in the Treatment of Heparin-Induced Thrombocytopenia.

    abstract::Heparin-induced thrombocytopenia (HIT) is a prothrombotic condition and it is associated with increased in vivo thrombin generation that needs to be treated with non-heparin anticoagulants such as direct thrombin inhibitors (DTIs). DTIs require parenteral administration and are associated with a non negligible risk of...

    journal_title:Journal of thrombosis and thrombolysis

    pub_type: 杂志文章

    doi:10.1007/s11239-015-1208-4

    authors: Sartori M,Favaretto E,Cini M,Legnani C,Cosmi B

    更新日期:2015-10-01 00:00:00

  • Relative risk of plaque erosion among different age and sex groups in patients with acute coronary syndrome.

    abstract::Postmortem studies reported plaque erosion is frequent in young women. Recent in vivo studies failed to show age and sex differences in the plaque erosion prevalence. The aim of this study was to investigate the prevalence of plaque erosion by age and sex among acute coronary syndromes (ACS) patients. From 1699 ACS pa...

    journal_title:Journal of thrombosis and thrombolysis

    pub_type: 临床试验,杂志文章,多中心研究

    doi:10.1007/s11239-019-01969-9

    authors: Kim HO,Kim CJ,Kim W,Cho JM,Soeda T,Takano M,Yan BP,Crea F,Niccoli G,Vergallo R,Minami Y,Higuma T,Kimura S,Boeder NF,Nef H,Adriaenssens T,Kurihara O,Thondapu V,Russo M,Yamamoto E,Sugiyama T,Lee H,Kakuta T,Yon

    更新日期:2020-04-01 00:00:00

  • Bivalirudin for left ventricular assist device thrombosis.

    abstract::Pump thrombosis remains a serious complication of implantable ventricular assist device therapy and is associated with increased risk of morbidity and mortality. Optimal management strategies remain controversial and are guided largely by limited literature and expert opinion. Medical management of pump thrombosis, in...

    journal_title:Journal of thrombosis and thrombolysis

    pub_type: 杂志文章

    doi:10.1007/s11239-018-1725-z

    authors: Weeks P,Sieg A,Rajapreyar I,Nathan S,Jumean M,Patel M,Radovancevic R,Kar B,Gregoric I

    更新日期:2018-11-01 00:00:00

  • Early changes in local hemostasis activation following percutaneous coronary intervention in stable angina patients: a comparison between drug-eluting and bare metal stents.

    abstract:BACKGROUND:Early change in local intracoronary hemostasis following drug-eluting (DES) and bare metal stent (BMS) implantation has never been assessed in stable angina patients. METHODS:Markers of local platelet activation (soluble glycoprotein V [sGPV] and P-Selectin [CD62P]), coagulation activation (tissue factor [T...

    journal_title:Journal of thrombosis and thrombolysis

    pub_type: 临床试验,杂志文章

    doi:10.1007/s11239-008-0266-2

    authors: Mahemuti A,Meneveau N,Seronde MF,Schiele F,Descotes-Genon V,Ecarnot F,Blonde MC,Mercier M,Racadot E,Bassand JP

    更新日期:2009-10-01 00:00:00

  • EPC mobilization after erythropoietin treatment in acute ST-elevation myocardial infarction: the REVEAL EPC substudy.

    abstract::Erythropoietin (EPO) was hypothesized to mitigate reperfusion injury, in part via mobilization of endothelial progenitor cells (EPCs). The REVEAL trial found no reduction in infarct size with a single dose of EPO (60,000 U) in patients with ST-segment elevation myocardial infarction. In a substudy, we aimed to determi...

    journal_title:Journal of thrombosis and thrombolysis

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1007/s11239-013-0944-6

    authors: Povsic TJ,Najjar SS,Prather K,Zhou J,Adams SD,Zavodni KL,Kelly F,Melton LG,Hasselblad V,Heitner JF,Raman SV,Barsness GW,Patel MR,Kim RJ,Lakatta EG,Harrington RA,Rao SV

    更新日期:2013-11-01 00:00:00

  • Resolution of acute lower extremity deep vein thrombosis with rivaroxaban compared to warfarin.

    abstract::Thrombosis resolution is an important component of treatment for deep vein thrombosis (DVT) and multiple anticoagulants are now available. It is unknown whether rivaroxaban contributes to a higher degree of thrombus resolution compared to conventional anticoagulation with warfarin. Our objective was to compare thrombu...

    journal_title:Journal of thrombosis and thrombolysis

    pub_type: 杂志文章

    doi:10.1007/s11239-019-01932-8

    authors: Houghton DE,Lekah A,Macedo TA,Hodge D,Saadiq RA,Little Y,Casanegra AI,McBane RD,Wysokinski WE

    更新日期:2020-02-01 00:00:00

  • The ADP receptor P2Y(1) mediates t-PA release in pigs during cardiac ischemia.

    abstract:BACKGROUND:The endothelial ADP receptor P2Y(1) is responsible for a large part of the reactive hyperemia following cardiac ischemia. Tissue plasminogen activator (t-PA) increases during reactive hyperemia. We postulated that the release of t-PA during reactive hyperemia could be mitigated through blocking the coronary ...

    journal_title:Journal of thrombosis and thrombolysis

    pub_type: 杂志文章

    doi:10.1007/s11239-007-0010-3

    authors: Olivecrona GK,Götberg M,Harnek J,Jacobson KA,Jern S,Erlinge D

    更新日期:2007-10-01 00:00:00

  • Central aortic pulse pressure, thrombogenicity and cardiovascular risk.

    abstract::High central aortic pulse pressure (CPP) and thrombin-induced platelet-fibrin clot strength (TIP-FCS) have been associated with ischemic outcomes in patients with coronary artery disease in separate studies. But, the ischemic risk associated with these factors has never been analyzed in a single study and their interr...

    journal_title:Journal of thrombosis and thrombolysis

    pub_type: 杂志文章

    doi:10.1007/s11239-017-1524-y

    authors: Chen G,Bliden KP,Chaudhary R,Liu F,Kaza H,Navarese EP,Tantry US,Gurbel PA

    更新日期:2017-08-01 00:00:00

  • The post-thrombotic syndrome: the forgotten morbidity of deep venous thrombosis.

    abstract::The postthrombotic syndrome (PTS) is the most common complication of deep venous thrombosis (DVT) yet has received little attention from clinicians and researchers. Clinically, PTS is characterized by chronic pain, swelling, heaviness and other signs in the affected limb. In severe cases, venous ulcers may develop. PT...

    journal_title:Journal of thrombosis and thrombolysis

    pub_type: 杂志文章,评审

    doi:10.1007/s11239-006-5574-9

    authors: Kahn SR

    更新日期:2006-02-01 00:00:00

  • Treatment of adults with intracranial hemorrhage on apixaban or rivaroxaban with prothrombin complex concentrate products.

    abstract::To analyze the efficacy and safety of activated prothrombin complex concentrates (aPCC) and four-factor prothrombin complex concentrates (4F-PCC) to prevent hematoma expansion in patients taking apixaban or rivaroxaban with intracranial hemorrhage (ICH). In this multicenter, retrospective study, sixty-seven ICH patien...

    journal_title:Journal of thrombosis and thrombolysis

    pub_type: 杂志文章

    doi:10.1007/s11239-020-02154-z

    authors: Castillo R,Chan A,Atallah S,Derry K,Baje M,Zimmermann LL,Martin R,Groysman L,Stern-Nezer S,Minokadeh A,Nova A,Huang W,Cang W,Schomer K

    更新日期:2021-01-01 00:00:00