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Warfarin time in therapeutic range of primary healthcare patients in the Western Cape, South Africa
Thesis (MMed)--Stellenbosch University, 2024.
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| Format: | Thesis |
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Stellenbosch : Stellenbosch University
2025
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| _version_ | 1867613788517171200 |
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| access_status_str | Open Access |
| author | Paleker, Masudah |
| author2 | Decloedt, Eric |
| author_browse | Decloedt, Eric Paleker, Masudah |
| author_facet | Decloedt, Eric Paleker, Masudah |
| author_sort | Paleker, Masudah |
| collection | Thesis |
| dc_rights_str_mv | Stellenbosch University |
| description |
Thesis (MMed)--Stellenbosch University, 2024. |
| format | Thesis |
| id | oai:scholar.sun.ac.za:10019.1/131881 |
| institution | Stellenbosch University (South Africa) |
| last_indexed | 2026-06-10T12:41:42.984Z |
| license_str | Other — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from SUNScholar — Stellenbosch University Repository |
| publishDate | 2025 |
| publishDateRange | 2025 |
| publishDateSort | 2025 |
| publisher | Stellenbosch : Stellenbosch University |
| publisherStr | Stellenbosch : Stellenbosch University |
| record_format | dspace |
| source_str | SUNScholar — Stellenbosch University Repository |
| spelling | oai:scholar.sun.ac.za:10019.1/131881 Warfarin time in therapeutic range of primary healthcare patients in the Western Cape, South Africa Paleker, Masudah Decloedt, Eric Dyers, Robin Stellenbosch University. Faculty of Medicine and Health Sciences. Dept. of Global Health. Health Systems and Public Health. Anticoagulants (Medicine) -- Therapeutic use -- South Africa Warfarin -- Therapeutic use -- South Africa UCTD Thesis (MMed)--Stellenbosch University, 2024. ENGLISH SUMMARY: Introduction: Warfarin therapy is the mainstay of anticoagulation treatment in South Africa. Challenges with warfarin include frequent INR monitoring, drug interactions, and varying therapeutic ranges. Time in therapeutic range (TTR) reflects the proportion of time when INR values are within therapeutic range. This study determined the TTR for warfarin-treated patients in a South African provincial primary healthcare (PHC) setting over five years. Methods: This was a retrospective cross-sectional analysis using routine data of all patients on warfarin therapy attending PHC facilities in Western Cape's public healthcare sector from 2018 to 2022 regardless of diagnosis. TTR was assessed using a therapeutic range of 2.0 – 3.0 and adherence was measured using dispensing data. Results: Among 20 342 patients on warfarin therapy, TTR could be calculated in 15 170 patients with a median (IQR) of 37.7% (16.9% – 56.9%). Only 5.0% of patients were classified as adherent and stabilised on warfarin. Patients who were classified as being adherent to warfarin had a median (IQR) TTR of 30.0% (7.7% – 54.2%). Younger age, more frequent INR monitoring and more hospital admissions were significantly associated with both TTR ≤ 65.0% and being adherent. Median (IQR) time to first therapeutic INR was 57 (27 – 141) days and was less when calculated using the Rosendaal method. Conclusion: We found suboptimal anticoagulation control in a South African PHC setting which requires strategies for improved patient care and anticoagulation. Given the low median TTR, alternatives to warfarin should be considered. AFRIKAANSE OPSOMMING: Geen opsomming beskikbaar. Masters 2025-04-07T07:12:32Z 2025-04-07T07:12:32Z 2024-12 Thesis https://scholar.sun.ac.za/handle/10019.1/131881 Stellenbosch University ii, 37 pages : illustrations application/pdf Stellenbosch : Stellenbosch University |
| spellingShingle | Anticoagulants (Medicine) -- Therapeutic use -- South Africa Warfarin -- Therapeutic use -- South Africa UCTD Paleker, Masudah Warfarin time in therapeutic range of primary healthcare patients in the Western Cape, South Africa |
| title | Warfarin time in therapeutic range of primary healthcare patients in the Western Cape, South Africa |
| title_full | Warfarin time in therapeutic range of primary healthcare patients in the Western Cape, South Africa |
| title_fullStr | Warfarin time in therapeutic range of primary healthcare patients in the Western Cape, South Africa |
| title_full_unstemmed | Warfarin time in therapeutic range of primary healthcare patients in the Western Cape, South Africa |
| title_short | Warfarin time in therapeutic range of primary healthcare patients in the Western Cape, South Africa |
| title_sort | warfarin time in therapeutic range of primary healthcare patients in the western cape south africa |
| topic | Anticoagulants (Medicine) -- Therapeutic use -- South Africa Warfarin -- Therapeutic use -- South Africa UCTD |
| url | https://scholar.sun.ac.za/handle/10019.1/131881 |
| work_keys_str_mv | AT palekermasudah warfarintimeintherapeuticrangeofprimaryhealthcarepatientsinthewesterncapesouthafrica |