Bleeding Incidence in Patients Administered with Warfarin at Secondary Hospitals in Yogyakarta Province

Warfarin is an oral anticoagulant most-commonly prescribed for prevention and treatment of thromboembolism. It is widely acknowledged that warfarin has both narrow therapeutic index and various drug-food interactions, thus carrying the risk of subtherapeutic or bleeding. Therefore, warfarin is among...

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Autores principales:	Vitarani D.A Ningrum, Sufiyah Sufiyah, Irine Dyah Widyastuti, Bacrie Sufriyanto Yusuf, Wahyudin Dullah
Formato:	article
Lenguaje:	EN
Publicado:	Universitas Gadjah Mada 2020
Materias:	warfarin dosage bleeding incidence secondary hospital Pharmacy and materia medica RS1-441
Acceso en línea:	https://doaj.org/article/a79f41e05d6d41da92b82fdd05cdceca
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spelling	oai:doaj.org-article:a79f41e05d6d41da92b82fdd05cdceca2021-11-15T06:08:47ZBleeding Incidence in Patients Administered with Warfarin at Secondary Hospitals in Yogyakarta Province2338-94272338-948610.22146/ijp.814https://doaj.org/article/a79f41e05d6d41da92b82fdd05cdceca2020-09-01T00:00:00Zhttps://jurnal.ugm.ac.id/v3/IJP/article/view/814https://doaj.org/toc/2338-9427https://doaj.org/toc/2338-9486Warfarin is an oral anticoagulant most-commonly prescribed for prevention and treatment of thromboembolism. It is widely acknowledged that warfarin has both narrow therapeutic index and various drug-food interactions, thus carrying the risk of subtherapeutic or bleeding. Therefore, warfarin is among the priority drugs to be evaluated to improve the quality of care for warfarin use. This study aimed to analyze the indications and dosage as well as the bleeding incidence in warfarin use at secondary hospitals in Yogyakarta. This research employed the retrospective cross-sectional design among outpatients and inpatients who received warfarin for a minimum of three days. Data of patient demographics, indications and doses of warfarin, incidence of bleeding, and other drugs interacting with warfarin were collected from the medical records for two years of research. The bleeding incidence could include conjunctival bleeding, melena, hematemesis, petechiae, purpura, ecchymosis, or hematochezia as was documented in the medical records. The research involved 139 patients with a majority of male patients and age range of >60 years. The three highest indications of warfarin use were CHF (37.41%), CHF-AF (23.74%), and AF (10.79%) with an average dose of 1.83±0.54 mg/day. Despite the administration of low doses of warfarin, four patients (2.90%) experienced bleeding with hematuria as the main clinical manifestation. This study recommends adjusting to a lower warfarin dose, particularly for the elderly who receive a combination with aspirin. In addition to a lower maintenance dose, a lower therapeutic target of INR should be further verified for Indonesian patients who receive warfarin.Vitarani D.A NingrumSufiyah SufiyahIrine Dyah WidyastutiBacrie Sufriyanto YusufWahyudin DullahUniversitas Gadjah Madaarticlewarfarindosagebleeding incidencesecondary hospitalPharmacy and materia medicaRS1-441ENIndonesian Journal of Pharmacy, Pp 217-228 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	warfarin dosage bleeding incidence secondary hospital Pharmacy and materia medica RS1-441
spellingShingle	warfarin dosage bleeding incidence secondary hospital Pharmacy and materia medica RS1-441 Vitarani D.A Ningrum Sufiyah Sufiyah Irine Dyah Widyastuti Bacrie Sufriyanto Yusuf Wahyudin Dullah Bleeding Incidence in Patients Administered with Warfarin at Secondary Hospitals in Yogyakarta Province
description	Warfarin is an oral anticoagulant most-commonly prescribed for prevention and treatment of thromboembolism. It is widely acknowledged that warfarin has both narrow therapeutic index and various drug-food interactions, thus carrying the risk of subtherapeutic or bleeding. Therefore, warfarin is among the priority drugs to be evaluated to improve the quality of care for warfarin use. This study aimed to analyze the indications and dosage as well as the bleeding incidence in warfarin use at secondary hospitals in Yogyakarta. This research employed the retrospective cross-sectional design among outpatients and inpatients who received warfarin for a minimum of three days. Data of patient demographics, indications and doses of warfarin, incidence of bleeding, and other drugs interacting with warfarin were collected from the medical records for two years of research. The bleeding incidence could include conjunctival bleeding, melena, hematemesis, petechiae, purpura, ecchymosis, or hematochezia as was documented in the medical records. The research involved 139 patients with a majority of male patients and age range of >60 years. The three highest indications of warfarin use were CHF (37.41%), CHF-AF (23.74%), and AF (10.79%) with an average dose of 1.83±0.54 mg/day. Despite the administration of low doses of warfarin, four patients (2.90%) experienced bleeding with hematuria as the main clinical manifestation. This study recommends adjusting to a lower warfarin dose, particularly for the elderly who receive a combination with aspirin. In addition to a lower maintenance dose, a lower therapeutic target of INR should be further verified for Indonesian patients who receive warfarin.
format	article
author	Vitarani D.A Ningrum Sufiyah Sufiyah Irine Dyah Widyastuti Bacrie Sufriyanto Yusuf Wahyudin Dullah
author_facet	Vitarani D.A Ningrum Sufiyah Sufiyah Irine Dyah Widyastuti Bacrie Sufriyanto Yusuf Wahyudin Dullah
author_sort	Vitarani D.A Ningrum
title	Bleeding Incidence in Patients Administered with Warfarin at Secondary Hospitals in Yogyakarta Province
title_short	Bleeding Incidence in Patients Administered with Warfarin at Secondary Hospitals in Yogyakarta Province
title_full	Bleeding Incidence in Patients Administered with Warfarin at Secondary Hospitals in Yogyakarta Province
title_fullStr	Bleeding Incidence in Patients Administered with Warfarin at Secondary Hospitals in Yogyakarta Province
title_full_unstemmed	Bleeding Incidence in Patients Administered with Warfarin at Secondary Hospitals in Yogyakarta Province
title_sort	bleeding incidence in patients administered with warfarin at secondary hospitals in yogyakarta province
publisher	Universitas Gadjah Mada
publishDate	2020
url	https://doaj.org/article/a79f41e05d6d41da92b82fdd05cdceca
work_keys_str_mv	AT vitaranidaningrum bleedingincidenceinpatientsadministeredwithwarfarinatsecondaryhospitalsinyogyakartaprovince AT sufiyahsufiyah bleedingincidenceinpatientsadministeredwithwarfarinatsecondaryhospitalsinyogyakartaprovince AT irinedyahwidyastuti bleedingincidenceinpatientsadministeredwithwarfarinatsecondaryhospitalsinyogyakartaprovince AT bacriesufriyantoyusuf bleedingincidenceinpatientsadministeredwithwarfarinatsecondaryhospitalsinyogyakartaprovince AT wahyudindullah bleedingincidenceinpatientsadministeredwithwarfarinatsecondaryhospitalsinyogyakartaprovince
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Bleeding Incidence in Patients Administered with Warfarin at Secondary Hospitals in Yogyakarta Province

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