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These three trials addressed how appropriately warfarin therapy is applied and how well anticoagulation goals are achieved in the greater U.S. community.
Kimmel and colleagues prospectively studied the effect of warfarin therapy adherence — assessed by a special computerized pill bottle — to anticoagulation control among 136 patients followed up at three anticoagulation clinics. Over a 32-week period, 36% of participants underadhered by more than 20%; underadherence conferred a twofold higher risk for under-target international normalized ratios (INRs). Overadherence by more than 10% (4% of participants) correlated significantly with likelihood of over-target INRs.
White and colleagues examined mortality, stroke, myocardial infarction (MI), b…