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Fixed dosing more effective than variable dosing for patients requiring warfarin: Presented at DG DISPATCH - AAN

By Richard Robinson

Special to DG News

SAN DIEGO, CA -- May 3, 2000 -- Fixed daily dosing of warfarin for chronic anticoagulation therapy is both simpler and more effective than variable dosing, research shows.

Long-term anticoagulation therapy for stroke prevention can be labor intensive, according to Nita A. Limdi, MD, of the University of Alabama Comprehensive Stroke Clinic, in Birmingham, AL. Close monitoring of patients is required to prevent complications from under- and over-dosing.

Dr. Limdi presented the results of a his study, "Superiority of fixed daily dosing of warfarin for chronic anticoagulation", on Tuesday (May 2) at the 52nd Annual Meeting of the American Academy of Neurology, held in San Diego, CA

Dr. Limdi and colleagues undertook a review of patient records over 12 months from two outpatient anticoagulation clinics within their institution. Clinic A, a stroke clinic, used fixed daily dosing of warfarin, while clinic B, a general clinic, allows variable dosing. Anticoagulation records of 47 patients from clinic A and 49 patients at clinic B were analyzed for dose changes, dose interventions (withholding or addition of a dose), and magnitude of dose change.

Patients on fixed doses had significantly fewer dose changes (66 vs. 103), and a trend toward fewer interventions (61 vs. 86). The total number of therapeutic changes (dose changes plus interventions) was also significantly less for clinic A (p=0.0024).

"Fixed dosing regimens appear to provide better anticoagulation control than variable dosing," Dr. Limdi said, and noted that not only does fixed dosing simplify the clinical regimen, but it increases patient compliance as well.

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