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OBJECTIVE Acute coronary syndromes (ACS) are life-threatening disorders requiring intensive medical management or invasive cardiovascular procedures. Limited data exist on the costs and resource utilization associated with ACS. METHODS This retrospective single-cohort study analyzed administrative claims data from employer-sponsored plans for patients(More)
BACKGROUND Anticoagulation can reduce quality of life, and different models of anticoagulation management might have different impacts on satisfaction with this component of medical care. Yet, to our knowledge, there are no scales measuring quality of life and satisfaction with anticoagulation that can be generalized across different models of(More)
We conducted a retrospective cohort study of thromboprophylaxis rates and the quality of anticoagulation control among patients with atrial fibrillation (AF) using a large, geographically diverse database of electronic medical records. The study population consisted of 13,709 AF patients treated in US outpatient physician practices. Approximately two-thirds(More)
BACKGROUND Some elderly patients with nonvalvular atrial fibrillation (NVAF) who might benefit from warfarin therapy do not receive it. OBJECTIVE The goal of this cross-sectional study was to identify physicians' attitudes and beliefs that are associated with their reported use of warfarin in case scenarios. METHODS A self-administered survey was mailed(More)
Background: Randomized control trials and observational studies show high-quality warfarin therapy leads to safe and effective stroke prophylaxis. In usual community practice, patient, physician and health care system factors are barriers to optimal anticoagulation. We examined the predictive relationship between inpatient and outpatient INR values in(More)
OBJECTIVE To examine the relationship between international normalized ratio (INR) and outcomes (major bleeding events and strokes) in patients with atrial fibrillation (AF) receiving anticoagulation with warfarin. METHODS A systematic review and metaanalysis of studies published in the English language between January 1, 1985, and October 30, 2002, was(More)
STUDY OBJECTIVE To determine the rates of concomitant use of drugs known to interact with warfarin by increasing the prothrombin time expressed as the international normalized ratio (INR), decreasing the INR, or increasing bleeding risk without apparent changes in INR in a cohort of patients receiving long-term warfarin therapy. DESIGN Retrospective,(More)
OBJECTIVE To measure the per-event health plan costs for acute and follow-up treatment not directed by a clinical study protocol in a group of commercially insured patients in 2 managed care organizations following an incident hospitalization that included a diagnosis for a venous thromboembolism (VTE) event. METHODS A cohort of patients with an incident(More)
BACKGROUND Warfarin is recommended for prevention of stroke in patients with atrial fibrillation who are at moderate or high risk, but requires intensive management to achieve safe and optimal anticoagulation control. Anticoagulation clinics are often used to administer warfarin therapy more effectively. OBJECTIVE To collect data from multiple sites and(More)
OBJECTIVE To examine warfarin utilization and clinical effectiveness among patients with nonvalvular atrial fibrillation within usual clinical care in a managed care system. RESEARCH DESIGN AND METHODS A retrospective analysis of health care claims for an approximately four million member managed care organization was performed. Health plan members with a(More)