La gestione del paziente in terapia anticoagulante orale in corso di pandemia: le soluzioni del Centro Emostasi e Trombosi di Savona
Monitoring of anticoagulant therapy during the COVID pandemic: the experience of the antithrombosis Centre in Savona (SV-Italy)

AUTORI

ABSTRACT

Monitoring of anticoagulant therapy during the COVID pandemic: the experience of the antithrombosis Centre in Savona (SV-Italy)

Introduction: the health emergency caused by the COVID-19 pandemic has forced health providers to rethink and reformulate patients’ care management, particularly during lockdown, in view of the need of stronger interactions between hospitals and local medical care with the aim of reducing the number of patients’ accesses to the hospitals. Patient under oral anticoagulant therapy, particularly those treated with antivitamin K drugs (AVK), need continuous therapy monitoring and drug dose adjustment, thus increasing their risk of possible SARS-CoV-2 exposure during the visits to the hospitals. The aim of this study is to illustrate, using appropriate indicators, the outcomes of an alternative clinical management of anticoagulated patients, adopting a new organizational model and an extended use of digital tools. Methods: a dedicated telephone number and a digital platform for therapy issuing were activated to maintain continuous patient surveillance and counselling activity. Specific indicators were: number of telephone calls received; number of digital therapy prescriptions; time in range (TTR) of AVK patients; number of major adverse events. Results: during the pandemic phase 10 215 telephone calls were received (with an increase of 200% compared to the pre-pandemic era). When compared to the values observed in the pre-pandemic period, the values of the indicators remained stable during the pandemic phase: TTR of AVK patients was 74% versus 74.6%; 22 minor and 2 major bleeding events were recorded versus 21 and 2 respectively. Discussion: the results obtained show, from the patient side, an optimal acceptance of the model proposed and, from the clinical side, the maintenance of the pre-pandemic quality standards of care

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