Home Care NetWork
Home Care Literature Reviews 2005
Thrombosis:
Nutescu EA. Point of care monitors for oral anticoagulant therapy. Semin Thromb Hemost. 2004;30:697-702.
This article reviews the use of portable coagulation monitors for prothrombin time-International Normalized Ratio testing. The author points out that these devices are highly desirable in terms of patient convenience and speed of results but cautions that the technology differs among the various devices so accuracy and precision need to be determined for individual devices. The various devices cannot be used interchangeably, and individual device performance cannot be generalized. A nice review.
Home Care Literature Reviews 2004
Thrombosis:
Nutescu EA. Point of care monitors for oral anticoagulant therapy. Semin Thromb Hemost. 2004;30:697-702.
This article reviews the use of portable coagulation monitors for prothrombin time-International Normalized Ratio testing. The author points out that these devices are highly desirable in terms of patient convenience and speed of results but cautions that the technology differs among the various devices so accuracy and precision need to be determined for individual devices. The various devices cannot be used interchangeably, and individual device performance cannot be generalized. A nice review.
Home Care Literature Reviews 2003
Thrombosis:
Segal JB, Bolger DT, Jenckes MW, Krishnan JA, Streiff MB, Eng J, Tamariz LJ, Bass EB. Outpatient therapy with low molecular weight heparin for the treatment of venous thromboembolism: a review of efficacy, safety, and costs. Am J Med. 2003;115:298-308.
This review of published evidence comparing the efficacy, safety, and costs of outpatient and inpatient treatment of venous thromboembolism found 8 studies (three randomized trials and five cohort studies) compared outpatient use of low molecular weight heparin with inpatient use of unfractionated heparin in 3762 patients. The incidence of recurrent deep venous thrombosis and major bleeding was similar in the two groups. Use of low molecular weight heparin was associated with shorter hospitalization and lower costs. Comparisons of outpatient and in-hospital use of low molecular weight heparin reported no difference in outcomes, but there were savings in hospitalization costs. Low molecular weight heparin was also found to be more cost saving and cost-effective than unfractionated heparin, with savings of 0% to 64% (median, 57%). Outpatient treatment of deep venous thrombosis with low molecular weight heparin is efficacious, safe, and cost-effective.
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