Patient Status Alert 

Each patient currently being monitored for Warfarin should have a patient status alert on the home screen and below the patient demographics box. The 'Action' link or the symbol will take you to the 'Warfarin Monitoring'  template. 


Third Party Software

Many practices use a third party application such as INR Star or Dawn AC, You will need to check to see what is recorded back to the patient record as these may not record the same data that you can from the Warfarin Monitoring template such as the time in TTR.  


Warfarin Monitoring Template

By using this template you can easily record everything you need to as part of the monitoring appointment.  


This includes 'Time in TTR', which can be calculated by clicking on the 'Warfarin Monitoring Data' link top right on the template, this calculator will open.  You can use the customise button to add various ranges which you can then select from the 'Set range' drop down menu or you can enter a custom range. The 'Time in TTR' percentage can then be recorded in the Warfarin Monitoring template.



Reporting

A number of reports have been put in place that you may find helpful. These can be accessed by going to 'Reporting > Clinical Reporting > Ardens > Best Practice > Cardiovascular', where you will see the following reports:


Safety Alerts

  • 2. SA: ?Review Warfarin as >10 INRs done in last 6 months
  • 2. SA: ?Review warfarin as miconazole oromucosal gel issued in last 6m
  • 2. SA: ?Review warfarin as most recent TTR 40-70% + no anticoagulant review in last 6m
  • 2. SA: ?Review warfarin as most recent TTR <40 + no anticoagulant review in last 6m
  • 2. SA: ?Review warfarin as 2 INR values <1.5 in last 6m + no anticoagulant review in last 6m

  • 2. SA: ?Review warfarin as 2 INR values >5 or 1 INR value >8 in last 6m + no anticoagulant review in last 6m

  • 2. SA: ?Review Warfarin as no FBC, UE or LFT in 12/12
  • 2. SA: ?Review Warfarin as no INR in last 3months and not INR self-monitoring


Case Finders

  • 3. CF: ?AF as on anticoagulant but coded as AF resolved
  • 3. CF: ?AF as on anticoagulant but no reason why (no DVT/PE/Thrombus/Thrombophilia)


Performance Indicators

  • 4. PI: AF - On anticoagulant and no HAS-BLED in last 13m
  • 4. PI: AF - On warfarin and no TTR recorded in the last 13m
  • 4. PI: AF - On warfarin and TTR <65%