title: Practical problems and resource implications with the use of warfarin for venous thromboembolism in patients with cancer.
abstract: BACKGROUND
  Oral anticoagulants present multiple practical problems for patients undergoing chemotherapy. To assess the practice implications of anticoagulation therapy, a review was carried out.
  
  
  METHODS
  A review of all patients with cancer treated with warfarin for venous thromboembolism (VTE) over a 1-year-period was carried out. Adverse events and therapeutic efficacy were assessed and the extra volume of work involved in monitoring was quantified.
  
  
  RESULTS
  Fifty-five patients with cancer and VTE were treated with warfarin from 07/04 to 06/05. Twenty-one invasive interventions required disruption of anticoagulation. There were eight admissions for haemorrhage. Nine patients died while on warfarin. A total of 1,379 coagulation tests were performed. There were 382 extra dayward visits attributable to warfarin monitoring. On treatment, 13 patients (24%) were changed from warfarin therapy to low molecular weight heparin (LMWH).
  
  
  CONCLUSIONS
  This study identifies and quantifies the extra resource utilization with warfarin therapy in patients undergoing chemotherapy.
authors.affiliation: Department of Medical Oncology, Beaumont Hospital, Dublin 9, Ireland. p_ob1_morris@yahoo.com
authors.forename: P G
authors.initials: PG
authors.lastname: Morris
authors.forename: C
authors.initials: C
authors.lastname: Davenport
authors.forename: D
authors.initials: D
authors.lastname: O'dwyer
authors.forename: C
authors.initials: C
authors.lastname: O'callaghan
authors.forename: O S
authors.initials: OS
authors.lastname: Breathnach
authors.forename: L
authors.initials: L
authors.lastname: Grogan
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use; D015897:Comorbidity; D005260:Female; D006495:Heparin, Low-Molecular-Weight / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology* / Q000517:prevention & control; D011655:Pulmonary Embolism / Q000453:epidemiology* / Q000517:prevention & control; D012189:Retrospective Studies; D013479:Superior Vena Cava Syndrome / Q000453:epidemiology* / Q000517:prevention & control; D054556:Venous Thromboembolism / Q000453:epidemiology* / Q000517:prevention & control; D014859:Warfarin / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight; D014859:Warfarin