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Background

In Australia, warfarin is a widely used anticoagulant for the prevention and treatment of pulmonary embolism and deep venous thrombosis and for prophylaxis of thromboembolic events in patients with atrial fibrillation, prosthetic heart valves and myocardial infarction. Its use, however, is complicated by the risk of excessive bleeding from over-anticoagulation which can be life threatening and which remains the most significant adverse event for patients receiving the drug. The most important predictor of outcome on warfarin therapy remains the clotting status of the patient (measured by the INR) and its control within the target range selected according to the indication for anticoagulation. Clinical studies have shown that anticoagulant management programs that incorporate patient education and regular monitoring of INR can reduce the incidence of serious misadventure and improve patient outcomes …