PT  - JOURNAL ARTICLE
AU  - William Sage
AU  - Amulya Gottiparthy
AU  - Paul Lincoln
AU  - Steven S L Tsui
AU  - Stephen J Pettit
TI  - Improving anticoagulation of patients with an implantable left ventricular assist device
AID  - 10.1136/bmjoq-2017-000250
DP  - 2018 Oct 01
TA  - BMJ Open Quality
PG  - e000250
VI  - 7
IP  - 4
4099  - http://bmjopenquality.bmj.com/content/7/4/e000250.short
4100  - http://bmjopenquality.bmj.com/content/7/4/e000250.full
SO  - BMJ Open Qual2018 Oct 01; 7
AB  - Patients supported with implantable left ventricular assist devices (LVAD) have a significant risk of bleeding and thromboembolic complications. All patients require anticoagulation with warfarin, aiming for a target international normalised ratio (INR) of 2.5 and most patients also receive antiplatelet therapy. We found marked variation in the frequency of INR measurements and proportion of time outside the therapeutic INR range in our LVAD-supported patients. As part of a quality improvement initiative, home INR monitoring and a networked electronic database for recording INR results and treatment decisions were introduced. These changes were associated with increased frequency of INR measurement. We anticipate that changes introduced in this quality improvement project will reduce the likelihood of adverse events during long-term LVAD support.