Warfarin therapy in older adults: managing treatment in the primary care setting.
Oral anticoagulant therapy with war farin is commonly used to prevent thromboembolic events in patients at risk. The degree of anticoagulation is variable among individuals and is influenced by many factors; therefore, patients must be monitored frequently to assess for potential adverse effects related to treatment. Individuals older than age 65 are at particular risk for thromboembolic events as well as anticoag ulant-related complications. Because of these factors, elderly individuals pose a unique challenge in maintain ing anticoagulant control. The purpose of this article is to revisit the role of warfarin therapy for elderly individ uals in the primary care setting and to provide nurse practitioners with the information necessary to prescribe and monitor this medication appropriately. This article provides indications for warfarin therapy and also identifies potential barriers to effective management with specific implications for the older population.
Perrero
Pam Perrin
PP
Geriatric Care Services, Greenville Hospital System, South Carolina, USA.
Willoughby
Deborah F
DF
Eggert
Julie A
JA
Counts
Sandra Harley
SH
D000284:Administration, Oral; D000367:Age Factors; D000368:Aged; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D016903:Drug Monitoring / Q000379:methods / Q000451:nursing / Q000592:standards; D005851:Geriatric Nursing / Q000379:methods; D006801:Humans; D019934:International Normalized Ratio; D009722:Nurse Practitioners; D024802:Nurse's Role; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D011320:Primary Health Care / Q000379:methods* / Q000592:standards; D012307:Risk Factors; D012449:Safety; D013923:Thromboembolism / Q000209:etiology / Q000517:prevention & control; D014859:Warfarin / Q000009:adverse effects / Q000627:therapeutic use*
D000925:Anticoagulants; D014859:Warfarin