Loading...
Considerable variation occurs in how clinicians adjust warfarin doses. To determine optimal thresholds for changing warfarin doses when international normalized ratios (INRs) are slightly outside the therapeutic range, researchers analyzed a database that included warfarin doses and INR values for 3961 patients whose INR targets were 2.0 to 3.0. Patients were observed for an average of 15 months. Clinicians who cared for these patients did not use dosing algorithms routinely.
As expected, INR values that triggered changes in warfarin doses varied among clinicians. On average, clinicians used INR thresholds of 1.8 and 3.2 to trigger increases and decreases, respectively, in warfarin doses; 68% of INR measurements were within the therapeutic r…