[Extent and quality of anti-coagulation treatment with coumarin derivatives by the Dutch Thrombosis Services].
OBJECTIVE
To obtain an impression of the extent and quality of the anti-coagulation treatment with coumarin derivatives carried out by the Thrombosis Services in the Netherlands.


METHODS
Descriptive.


METHODS
Data were drawn from the medical annual reports of 62 of the 63 Thrombosis Services in the Netherlands over the period 1998-2002. In 2002 the Thrombosis Services treated 325,072 patients and performed 4,469,730 INR laboratory tests. The half-yearly figures produced by the Thrombosis Services were calculated as an average percentage per year per thrombosis service and then recalculated as a percentage per year.


RESULTS
Seventy-three per cent of the patients were treated for an arterial and 27% for a venous indication. Depending on the required intensity of anticoagulation a mean of 74-78% of the long-term treated patients fell within the therapeutic range and a mean of 6-10% below. The mean number of major bleedings per 100 treatment years was 1.0. A mean of 79% of the patients was treated with acenocoumarol and 21% with phenprocoumon. When acenocoumarol was used, a mean of 72-77% fell within the therapeutic range and in the case of phenprocoumon 79-82%. In the last few years the number of patients had increased due to a growing number of patients treated for atrial fibrillation. The percentages of INR within the therapeutic range were unchanged or showed a slight increase.


CONCLUSIONS
The quality of the anticoagulation therapy with coumarin derivatives was good or acceptable.
van Geest-Daalderop
J H
JH
Jeroen Bosch Ziekenhuis, afd. Trombosedienst, Deutersestraat 2, 5223 GV 's-Hertogenbosch. trombo.denbosch@tip.nl
Sturk
A
A
Levi
M
M
Adriaansen
H J
HJ
D000074:Acenocoumarol / Q000009:adverse effects / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy; D003374:Coumarins / Q000009:adverse effects / Q000627:therapeutic use*; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D019934:International Normalized Ratio; D009426:Netherlands; D010644:Phenprocoumon / Q000009:adverse effects / Q000627:therapeutic use; D011787:Quality of Health Care; D013927:Thrombosis / Q000188:drug therapy*; D016896:Treatment Outcome
D000925:Anticoagulants; D003374:Coumarins; D000074:Acenocoumarol; D010644:Phenprocoumon