Issues Surrounding Warfarin Therapy

During this one-on-one interview, Michael A. Evans, BS, RPh, of Geisinger Health System, discusses the use of warfarin as a treatment and/or prevention option for thromboembolic complications and explains why management of patients on warfarin is difficult.

Warfarin therapy, explains Mr Evans, requires frequent monitoring as warfarin is associated with numerous food interactions, drug-drug interactions, and disease interactions. Mr Evans also discusses warfarin’s mechanism of action and highlights specific foods, drugs, and conditions that affect the efficacy and safety of warfarin therapy.

Some patients prefer the frequent monitoring required with warfarin therapy, as it means more contact with healthcare providers; however, frequent visits for laboratory testing and monitoring place a burden on the healthcare system. As models of healthcare delivery change, patient access to care will become more challenging, says Mr Evans.

The number of testing and monitoring visits associated with warfarin therapy can potentially be reduced through the use of home INR monitoring devices, which allow patients to self-test and provide test results to their monitoring clinicians. However, the use of home INR monitoring devices is still resource utilization—intensive, notes Mr Evans.

The recent approval of direct-acting oral anticoagulants can benefit patient and clinicians, as these agents do not require routine monitoring, adds Mr Evans.