Factors Associated with Time in Therapeutic Range among Patients on Oral Anticoagulation Therapy in a Tertiary Teaching and Referral Hospital in Kenya

  • Salome Karuri Department of Pharmaceutics and Pharmacy Practice, University of Nairobi
  • David Nyamu Department of Pharmaceutics and Pharmacy Practice, University of Nairobi
  • Sylvia Opanga Department of Pharmaceutics and Pharmacy Practice, University of Nairobi
  • Tom Menge Kenyatta National Hospital, P.O. Box 20273-00202, Nairobi, Kenya
Keywords: Warfarin, time in therapeutic range, oral anticoagulation

Abstract

Oral anticoagulation with warfarin is challenging owing to the drug’s
narrow therapeutic index. Achievement of therapeutic range ensures
safety and efficacy of warfarin therapy. A retrospective study of four
hundred and six patients on warfarin anticoagulation was conducted at
Kenyatta National Hospital, Kenya for the period between January 2014
and June 2016. The percentage of follow-up time spent in therapeutic
international normalized ratio range was computed by Rosendaal linear
interpolation method. Factors associated with this time were also explored.
The mean age of the participants was 42.7±16.9 years and the ratio of
females to males was 3:1. The mean percentage of time spent in therapeutic
international normalized ratio range was 31.1%. Poor anticoagulation
control was associated with congestive heart failure (p=0.047) and the
independent predictor of time in therapeutic range was renal dysfunction
(β= -13.3, 95% CI: -25.9, -0.8, p=0.038) suggesting that management of
these patients needs to be intensified.

Published
2020-02-03
How to Cite
Karuri, S., Nyamu, D., Opanga, S., & Menge, T. (2020). Factors Associated with Time in Therapeutic Range among Patients on Oral Anticoagulation Therapy in a Tertiary Teaching and Referral Hospital in Kenya. The East and Central African Journal of Pharmaceutical Sciences, 22(3), 85-95. Retrieved from https://uonjournals.uonbi.ac.ke/ojs/index.php/ecajps/article/view/293
Issue
Vol 22 No 3 (2019): September-December 2019
Section
Articles