Full Text Available
Note: Clicking the button above will open the full text document at the original institutional repository in a new window.
International normalised ratio control in a non-metropolitan setting in Western Cape Province, South Africa
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 Mu...
Saved in:
| Main Author: | |
|---|---|
| Other Authors: | |
| Format: | Thesis |
| Language: | English |
| Published: |
Department of Medicine
2022
|
| Subjects: | |
| Tags: |
No Tags, Be the first to tag this record!
|
| _version_ | 1867613229949124608 |
|---|---|
| access_status_str | Open Access |
| author | Prinsloo, Dawid Nicolaas |
| author2 | Ntsekhe, Mpiko |
| author_browse | Ntsekhe, Mpiko Prinsloo, Dawid Nicolaas |
| author_facet | Ntsekhe, Mpiko Prinsloo, Dawid Nicolaas |
| author_sort | Prinsloo, Dawid Nicolaas |
| collection | Thesis |
| description | 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. |
| format | Thesis |
| id | oai:open.uct.ac.za:11427/36043 |
| institution | University of Cape Town (South Africa) |
| language | eng |
| last_indexed | 2026-06-10T12:32:50.328Z |
| license_str | Not specified — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository |
| publishDate | 2022 |
| publishDateRange | 2022 |
| publishDateSort | 2022 |
| publisher | Department of Medicine |
| publisherStr | Department of Medicine |
| record_format | dspace |
| source_str | UCTD — University of Cape Town Open Access Repository |
| spelling | oai:open.uct.ac.za:11427/36043 International normalised ratio control in a non-metropolitan setting in Western Cape Province, South Africa Prinsloo, Dawid Nicolaas Ntsekhe, Mpiko Gould, T J Medicine 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. 2022-03-10T14:05:17Z 2022-03-10T14:05:17Z 2021 2022-03-10T14:04:47Z Master Thesis Masters MMed http://hdl.handle.net/11427/36043 eng application/pdf Department of Medicine Faculty of Health Sciences |
| spellingShingle | Medicine Prinsloo, Dawid Nicolaas International normalised ratio control in a non-metropolitan setting in Western Cape Province, South Africa |
| thesis_degree_str | Master's |
| title | International normalised ratio control in a non-metropolitan setting in Western Cape Province, South Africa |
| title_full | International normalised ratio control in a non-metropolitan setting in Western Cape Province, South Africa |
| title_fullStr | International normalised ratio control in a non-metropolitan setting in Western Cape Province, South Africa |
| title_full_unstemmed | International normalised ratio control in a non-metropolitan setting in Western Cape Province, South Africa |
| title_short | International normalised ratio control in a non-metropolitan setting in Western Cape Province, South Africa |
| title_sort | international normalised ratio control in a non metropolitan setting in western cape province south africa |
| topic | Medicine |
| url | http://hdl.handle.net/11427/36043 |
| work_keys_str_mv | AT prinsloodawidnicolaas internationalnormalisedratiocontrolinanonmetropolitansettinginwesterncapeprovincesouthafrica |