ANTICOAGULATION THERAPY AND PRIMARY-CARE INTERNAL-MEDICINE - A NURSE PRACTITIONER MODEL FOR COMBINED CLINICAL SERVICE

The anticoagulation clinics at the University of Virginia Health Scien ces Center and the University of California at Davis Medical Center ar e nurse-practitioner-operated, are affiliated with the general medicin e clinic, and rely on portable prothrombin time (PT) monitors that use whole blood and provide timely as well as accurate results reported i n PT seconds or as the international normalized ratio (INR). On-site P T/INR testing at these clinics simplifies anticoagulation, mandates di rect patient contact, and facilitates primary as well as comprehensive care for patients requiring multispecialty services in large tertiary care centers. Encounters are relatively brief, averaging 19 minutes; 72% of the encounter time involves anticoagulation care and 28% involv es primary care. Anticoagulation results using portable PT/INR monitor s are safe and accurate based on comparisons with results from clinics relying on standard instruments.