Comparing follow-up of patients with vitamin K antagonists in a health center: pre- and post- COVID-19 pandemic
DOI:
https://doi.org/10.11606/issn.2176-7262.rmrp.2023.204617Keywords:
Anticoagulants, Warfarin, International normalized Ratio, COVID-19, SARS-CoV-2Abstract
Introduction and objectives: During the COVID-19 pandemic, the follow-up of patients treated with vitamin K antagonists (VKAs) may have been affected. This study aims to compare how these patients were monitored preand post-COVID-19 pandemic and understand the impact of non-face-to-face appointments on their follow-up. Methods: We conducted a retrospective cohort study in a Portuguese Health Center. The study included patients treated with VKAs and followed at the Health Center for international normalized ratio (INR) monitoring between March 2019 and March 2021. Data collected: sex, age, type of VKA; INR; date of INR assessment, type of appointment (face-to-face or phone/e-mail). Rosendaal’s method was used to calculate pre-COVID-19 and post-COVID-19 time in therapeutic range (TTR). Good TTR control was defined if values ≥ 70%. Results: 44 patients were included. The mean TTR in the pre-COVID-19 period was 64.55% (95% CI: 58.10 - 71.00%). The post-COVID-19 mean was slightly higher (+ 2.26%), 66.81% (95% CI: 59.66 - 73.97%), but the difference was not statistically significant (p = 0.576). The use of non-face-to-face appointments did not contribute to worsening post-pandemic TTR, showing no lower follow-up than during pre-pandemic period in which all contacts were face-to-face [CI (95%) -0.397 - 0.196 for a reference range -0.489 - 0.693]. Conclusions: The TTR value in both periods was similar and lower than the value defined for effective hypocoagulation. The use of non-face-to-face consultation in the post-COVID-19 period does not seem to have influenced the quality of hypocoagulation.
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Copyright (c) 2023 Ana Sofia Dias Aveiro, Vítor Daniel Pereira Vaz, Soraia Antunes Pereira Ribeiro, Tiago José Reis Pereira, Ana Margarida Leitão da Silva Santos, Beatriz Nunes Graça, Marta Costa Cardoso, Carla Maria Santos Silva
This work is licensed under a Creative Commons Attribution 4.0 International License.
