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Better instructions reduce complications among patients using common blood thinner
Date:10/27/2008

PHILADELPHIA Patients who report receiving written and verbal instructions on the proper way to take the blood thinner warfarin are significantly less likely to suffer the serious gastrointestinal and brain bleeding problems that are associated with misuse of the drug, according to new research from the University of Pennsylvania School of Medicine. The study, published in the October issue Journal of General Internal Medicine, also shows that patients who see only one physician and fill their prescription at a single pharmacy are less apt to experience serious bleeding events.

Lead author Joshua P. Metlay, MD, PhD, an Associate Professor in Penn's division of General Internal Medicine and a Senior Scholar in the Center for Clinical Epidemiology and Biostatistics, found that patients who reported receiving medication instructions from a physician and a nurse plus a pharmacy worker were 60 percent less likely to experience a serious bleeding problem over the following two years. Since the serious side effects of warfarin use are often linked to hospitalizations, the Penn researchers theorize that improved patient communication -- which can help clarify questions about dosing, other drugs to avoid while taking warfarin, and early symptoms of bleeding problems -- could prevent a substantial number of injuries and resulting hospitalizations.

"While we do not know the specific mechanism linking the medication instructions to reduce bleeding risk, it is likely that improved communication about medications leads to increased drug adherence and earlier recognition of medication side effects," Metlay says.

Metlay's team, in collaboration with the Pennsylvania Pharmaceutical Assistance Contract for the Elderly (PACE), studied 2,346 older adults taking warfarin for problems including heart rhythm abnormalities, deep vein thrombosis, stroke, heart valve replacements or pulmonary embolism. Using data provided by the Pennsylvania Healthca
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Contact: Holly Auer
holly.auer@uphs.upenn.edu
215-349-5659
University of Pennsylvania School of Medicine
Source:Eurekalert

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