The largest ever study into the administration of blood thinning drugs like Warfarin has concluded that dosages calculated by computer are at least as safe and reliable as those provided by trained medical professionals.
Increasing evidence of the value of these anticoagulant drugs in a wide range of clinical disorders such as abnormal heart rhythm, or atrial fibrillation, has led to a rapid rise in their use around the world.
However, prescribing the right oral dose of anticoagulant to patients, even for experienced medical staff, can be problematic as individuals differ greatly in response to a given dose: too high a dose for an individual and the blood becomes too thin and can lead to internal bleeding, too low and the blood clots too readily.
Previous studies supporting the use of computer-assisted dosage have depended solely on laboratory results and have not been sufficiently large to determine whether observed improvements in normal blood clotting time – known as the ‘international normalised ratio’ or INR – resulted in clinical benefit and improved safety.
But now results from a four-year clinical trial organised from The University of Manchester have shown that computer-assisted dosage is as good, if not better, at prescribing the correct dosage to normalise and maintain the correct INR in patients as dosages given by medical professionals.
“The need for computer assistance arises from the massive demand for oral anticoagulants following their success at treating an increasing number of thrombotic and embolic conditions,” said Professor Leon Poller, who headed the research in Manchester’s Faculty of Life Sciences.
“This increased demand has been overwhelming and stretched medical facilities worldwide to their limits. Computer dosage was introduced as a way to meet this demand but its safety and effectiveness had never been established.”
The study, carried out in 32 medical centres across the European Union and involving more than 13,000 patients, analysed nearly 400,000 INR tests, divided evenly between manual and computer-assisted dosage.