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Monitoring dose crucial for anticoagulants

Physicians find it a challenge to manage patients' progress on these decades-old but still important drugs.

By Susan J. Landers, amednews staff. July 3, 2006.

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Washington -- William Thomas, MD, a geriatrician who has written extensively on improving the lives of elderly people, wishes that the anticoagulant warfarin glowed bright orange so patients would be reminded that this is a pill of a different color in more ways than one. He's not sure all patients know this one little pill can have such a good -- or bad -- effect on health.

Surveys commissioned by a Washington, D.C.-based advocacy group, the National Consumers League, for its SOS Rx project reinforce that view. Participating patients revealed that they need more help from their physicians or other health care professionals to manage this therapy successfully. Physicians surveyed also indicated that monitoring patients on anticoagulants often was a challenging undertaking.

Dr. Thomas joined NCL representatives and others for a May 31 briefing about the surveys and about anticoagulants in general.

About 4 million Americans currently take the medication warfarin to prevent strokes, blood clots and other serious health problems, according to the league. But despite their frequent use and long history -- warfarin has been around for more than 50 years --anticoagulants remain difficult to manage. Close blood monitoring requires frequent office or lab visits, and dangerous interactions can occur with many other medications, herbal supplements, vitamins and food.

According to NCL's patient survey, of the 426 users of anticoagulants queried, 93% had experienced adverse reactions such as bleeding, bruising or dizziness, but only about half changed their behavior to prevent the reaction from reoccurring. Many had not even reported the symptoms to their physicians.