TY - JOUR
T1 - Profiles of patients on warfarin anticoagulation therapy in a leading tertiary referral hospital in Kenya; findings and implications for Kenya
AU - Nyamu, David Gitonga
AU - Guantai, Anastasia Nkatha
AU - Osanjo, George Oyamo
AU - Godman, Brian
AU - Aklillu, Eleni
N1 - Funding Information:
This work was entirely self-funded by the corresponding author. The authors acknowledge all staff at anticoagulation clinics of KNH for the immeasurable support during the study. The authors also acknowledge all patients who willingly participated in the study.
Publisher Copyright:
© 2020, © 2020 Informa UK Limited, trading as Taylor & Francis Group.
PY - 2020/3/3
Y1 - 2020/3/3
N2 - Background: Patients’ profiles affect the outcome with warfarin; however, this data, and its implications, is scarce in resource-poor countries without access to pharmacogenetics or regular INR testing. Objectives: To characterize the profiles of patients on long-term warfarin therapy and subsequently use these to guide future anticoagulation management. Methods: Cross-sectional study among 180 adult patients receiving warfarin therapy in at a leading referral hospital in Kenya. Sociodemographic characteristics were obtained through face-to-face interviews. Details of warfarin therapy, concomitant medication and comorbidities were retrieved from medical records. Associations between patients’ profiles and the clinical indications of anticoagulation were computed at p ≤ 0.05. Results: Warfarin maintenance dose was 6.17 (±2.75) mg per day. Venous thromboembolism (56.6%) amongst obese patients (p = 0.0019) and cardioembolic events (48.3%) among males (p = 0.0316) aged ≤50 years (p = 0.0436) whose body mass indices were ≤ 25 (p < 0.0001) were the most common indications. Two-fifths and 45.0% of the patients had at least one other disease and concomitant medications. Conclusions: Long term warfarin therapy among Kenyans is mainly for overweight or lean middle-aged individuals suffering from venous or cardioembolic diseases. Studies should correlate patients’ profiles with warfarin response to guide future management.
AB - Background: Patients’ profiles affect the outcome with warfarin; however, this data, and its implications, is scarce in resource-poor countries without access to pharmacogenetics or regular INR testing. Objectives: To characterize the profiles of patients on long-term warfarin therapy and subsequently use these to guide future anticoagulation management. Methods: Cross-sectional study among 180 adult patients receiving warfarin therapy in at a leading referral hospital in Kenya. Sociodemographic characteristics were obtained through face-to-face interviews. Details of warfarin therapy, concomitant medication and comorbidities were retrieved from medical records. Associations between patients’ profiles and the clinical indications of anticoagulation were computed at p ≤ 0.05. Results: Warfarin maintenance dose was 6.17 (±2.75) mg per day. Venous thromboembolism (56.6%) amongst obese patients (p = 0.0019) and cardioembolic events (48.3%) among males (p = 0.0316) aged ≤50 years (p = 0.0436) whose body mass indices were ≤ 25 (p < 0.0001) were the most common indications. Two-fifths and 45.0% of the patients had at least one other disease and concomitant medications. Conclusions: Long term warfarin therapy among Kenyans is mainly for overweight or lean middle-aged individuals suffering from venous or cardioembolic diseases. Studies should correlate patients’ profiles with warfarin response to guide future management.
KW - Kenya
KW - Warfarin
KW - Warfarin Anticoagulation Therapy
KW - patient Profiles
UR - http://www.scopus.com/inward/record.url?scp=85080957833&partnerID=8YFLogxK
U2 - 10.1080/14779072.2020.1734452
DO - 10.1080/14779072.2020.1734452
M3 - Article
C2 - 32090626
AN - SCOPUS:85080957833
SN - 1477-9072
VL - 18
SP - 165
EP - 173
JO - Expert Review of Cardiovascular Therapy
JF - Expert Review of Cardiovascular Therapy
IS - 3
ER -