The Pharmaceutical Journal
Vol 279 No 7463 p121
4 August 2007

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Computers on a par with medical staff when calculating anticoagulant dose changes

Computers are as good as trained medical staff at calculating anticoagulant dose adjustments, a study involving over 13,000 patients has found.

Computer-assisted adjustment achieved international normalised ratios within target 65.9 per cent of the time, compared with 64.7 per cent for manual dosage adjustment. This “time-in-range” difference between the two methods was not statistically significant.

In addition, there were fewer cases of deep vein thrombosis in the computer-assisted adjustment group (115 vs 152, P<0.01), and there was no evidence that computer-assisted adjustment put patients at added risk of other adverse events.

Leon Poller, project leader for the study, told The Journal that the results validate what is already happening in practice in many centres — the replacement of dose adjustment by medical staff with computer-assisted adjustment.

A total of 32 centres recruited 13,219 patients and provided 18,617 patient-years of data. The study used two computer programs, PARMA 5, a new program developed from one used in Italy, and DAWN AC, which is used in 200 centres in the UK.

The results were presented at the International Society on Thrombosis and Haemostasis conference in Geneva, Switzerland, last month.