EVALUATION OF A NURSE SPECIALIST ANTICOAGULANT SERVICE

Safe levels of anticoagulation are normally considered to be achieved if patients are maintained within their therapeutic international norm alized ratio (INR) range for 70% or more time, but evidence in the Uni ted Kingdom suggests that this is often not attained. Recently, altern ative models in the management of out-patient anticoagulation have bee n investigated with favourable results. We report on a study which com pared a consultant anticoagulant service (CAS) with a nurse specialist service (NSAS). A sequential design was used with data collected on t he consultant run service (GAS), followed by similar data on a NSAS ov er two 6 month periods. Two patient groups were recruited: those newly referred (group A) and those on long-term treatment (group B). Outcom es were the proportion of time patients spent within INR range, docume ntation of relevant clinical details, number of drugs taken which may adversely interact with and/or inhibit haemostatic function and patien t knowledge, The results indicate that the NSAS was as good as the CAS in maintaining therapeutic control and better at documenting relevant clinical details in reducing the number of drugs taken which may adve rsely interact with and/or inhibit haemostatic function and in improvi ng some aspects of patient knowledge.