Ellen T. Murray

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BACKGROUND Anticoagulants are more effective than antiplatelet agents at reducing stroke risk in patients with atrial fibrillation, but whether this benefit outweighs the increased risk of bleeding in elderly patients is unknown. We assessed whether warfarin reduced risk of major stroke, arterial embolism, or other intracranial haemorrhage compared with(More)
BACKGROUND There is increased pressure on primary care physicians to monitor oral anticoagulation. OBJECTIVE To test the null hypothesis that oral anticoagulation care can be provided at least as well in primary care through a nurse-led clinic, involving near-patient testing and computerized decision support software, compared with routine hospital(More)
OBJECTIVE To determine the clinical effectiveness of self management compared with routine care in patients on long term oral anticoagulants. DESIGN Multicentre open randomised controlled trial. SETTING Midlands region of the UK. PARTICIPANTS 617 patients aged over 18 and receiving warfarin randomised to intervention (n = 337) and routine care (n =(More)
OBJECTIVES To assess whether screening improves the detection of atrial fibrillation (cluster randomisation) and to compare systematic and opportunistic screening. DESIGN Multicentred cluster randomised controlled trial, with subsidiary trial embedded within the intervention arm. SETTING 50 primary care centres in England, with further individual(More)
OBJECTIVES To determine the most cost-effective method of screening for atrial fibrillation (AF) in the population aged 65 years and over, as well as its prevalence and incidence in this age group. Also to evaluate the relative cost-effectiveness of different methods of recording and interpreting the electrocardiogram (ECG) within a screening programme. (More)
There is a limited evidence base for self-testing and -management for oral anticoagulation management. Available data suggest that these are credible models for a significant minority of patients if underpinned by structured training and follow-up. The guidelines presented are necessarily consensual and outline procedures for patient selection, training,(More)
BACKGROUND Increasing indications for oral anticoagulation has led to pressure on general practices to undertake therapeutic monitoring. Computerized decision support (DSS) has been shown to be effective in hospitals for improving clinical management. Its usefulness in primary care has previously not been investigated. AIM To test the effectiveness of(More)
BACKGROUND The increase in numbers of patients receiving warfarin treatment has led to the development of alternative models of service delivery for oral anticoagulant monitoring. Patient self management for oral anticoagulation is a model new to the UK. This randomised trial was the first to compare routine primary care management of oral anticoagulation(More)
AIMS To evaluate the evidence of therapeutic international normalised ratio (INR) control reporting and to provide recommendations for future reporting, particularly for research and audit purposes. METHODS A systematic review of literature published over a five year period describing therapeutic INR control. Papers were identified from the Medline(More)
AIM To compare the reliability and relative costs of three international normalised ratio (INR) near patient tests. MATERIALS Protime (ITC Technidyne), Coaguchek (Boehringer Mannheim), and TAS (Diagnostic Testing). METHODS All patients attending one inner city general practice anticoagulation clinic were asked to participate, with two samples provided(More)