Profiles of patients on warfarin anticoagulation therapy in a leading tertiary referral hospital in Kenya; findings and implications for Kenya.
Date
2019Author
Nyamu, DG
Guantai, AN
Osanjo, GO
Godman, B
Aklillu, E
Type
ArticleLanguage
enMetadata
Show full item recordAbstract
Background: Patients' profiles affect the outcome with warfarin; however, this data, and its implications, is scarce in resource-poor countries such as Kenya without access to pharmacogenetics or regular INR testing.Objectives: To characterize the profiles of patients on long-term warfarin therapy and subsequently use the findings to guide future anticoagulation management.Methods: Cross-sectional study undertaken among 180 adult patients receiving warfarin therapy in anticoagulation clinics at a leading referral hospital in Kenya. Sociodemographic characteristics were obtained through face-to-face interviews. Details of warfarin therapy, concomitant medication and comorbidities were retrieved from medical records. Associations between patients' profiles and the clinical indications of anticoagulation were computed p≤0.05.Results: Warfarin maintenance dose was 6.17 (±2.75) mg per day. Over 70% of patients received warfarin maintenance doses of ≥6mg per day. Venous thromboembolism (56.6%) amongst obese patients (p=0.0019) and cardioembolic events (48.3%) among males (p=0.0316) aged ≤50 years (p=0.0436) whose body mass indices were ≤ 25 (p<0.0001) were the most common indications. Two-fifths and 45.0% of the patients had at least one other disease and concomitant medications.Conclusions: Long term warfarin therapy among Kenyans is mainly for overweight or lean middle-aged individuals suffering from venous or cardioembolic diseases and requires high daily doses. Studies should correlate patients' profiles with warfarin response to guide future management.
Citation
Expert Rev Cardiovasc Ther. 2020 Feb 24Publisher
University of Nairobi
Rights
Attribution-NonCommercial-NoDerivs 3.0 United StatesUsage Rights
http://creativecommons.org/licenses/by-nc-nd/3.0/us/Collections
- Faculty of Health Sciences (FHS) [10385]
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