WARFARIN 2.0 - A COMPUTER-PROGRAM FOR WARFARIN MANAGEMENT - DESIGN AND CLINICAL USE

Warfarin 2.0 is a computer program that helps physicians optimize trea tment of outpatients with warfarin. The main reason for its developmen t was to achieve a good anticoagulation level, avoiding both undertrea tment -- which causes thromboembolic complications -- and overtreatmen t -- which causes hemorrhagic complications. The program was also desi gned to help educate the anticoagulated patient, standardize warfarin management and audit results of what had been done. The philosophy of continuous quality improvement was applied. Warfarin 2.0 is in clinica l operation in the University Hospital, Montevideo, Uruguay, and it ha s also been used since the end of 1993 in the Favaloro Foundation, Dep t. of Hematology, Buenos Aires, Argentina. The results from the first 15 months of use in Montevideo showed an increase in the number of pat ients being followed (from 91 to 132) and the average number of visits per patient (from one visit every 10.6 weeks to one every 6.5 weeks): The frequency of visits has been in the internationally accepted rang es since the program was implemented. Better anticoagulation levels we re achieved after an adjusting period. Unfortunately, the number of un dertreated patients is still large, and a thorough analysis of the dat a is going to be undertaken to continue improving warfain management.