Aga Khan University Hospital has introduced the first dedicated Anticoagulation Therapy Clinic in Pakistan for safe and effective management of patients on blood thinning medications.
“Every day we have new patients coming in with heart and blood diseases, many of whom need to be placed on drugs that thin the blood and prevent fatal complications,” said Dr Bushra Moiz, Associate Professor, Haematology, at the patient awareness session held at the Stadium Road Campus on May 29.
“Warfarin and heparin are gold standards for out-patient and in-patient therapies, however, if their levels are not monitored carefully then they can cause uncontrolled bleeding or even severe clotting of vessels causing strokes,” she added. “The main objectives of this new management service are to provide patient education and timely interventions.”
Explaining the feasibility and impact of such clinics, she added that various research studies have shown that close monitoring of blood therapies reduces potential complications: the risk for bleeding due to drug overdose is between 2.8 and 8.1 per cent in routine medical care versus 1.4 and 3.3 per cent when a patient is managed in a dedicated anticoagulation clinic.
Similarly, the risk to form blood clots due to poor and inadequate anticoagulation is between 6.2 and 8.1 per cent in routine clinics, but is much lower at 0.7 and 6.3 per cent when a patient is managed in specific anticoagulation clinic.
“Dedicated clinics in the long run prove to be more cost-effective with increased patient satisfaction,” explained Dr Moiz.
Dr Usman Shaikh, Associate Professor & Section Head, Haematology, also discussed at length the management of patients on warfarin.
“Patients’ and physicians’ education is important for understanding the risks and benefits of warfarin and ultimately their willingness to utilize the therapy,” he said.
To avoid potential complications, Dr Shaikh advised patients to take the prescribed dose on time, report any bruising or bleeding immediately, avoid contact sports and activities carrying a risk of head injury, and keep the primary care booklet up-to-date.
He also emphasized about drug-drug, drug-food and drug-disease interactions.
“In Pakistan, 40 per cent of people who have an episode of thrombosis, which is not provoked by other causes, have an inherited condition known as thrombophilia (that increases the risk of thrombosis). Presence of thrombophilia may warrant life-long anticoagulant therapy. Therefore, it is necessary to identify this group of patients through proper thrombophilia testing,” stressed Dr Farheen Karim, Instructor, Section of Haematology.
“Since thrombophilia screening is expensive and time-consuming, it is important to target the right people at the right time,” she added.
Dr Natasha Ali, Senior Instructor, Section of Haematology said that with the advent of newer oral anticoagulant drugs like dabigatran etexilate and rivaroxaban, it seems that physicians are eager to change the paradigm of anticoagulant therapy, especially because these agents require no coagulation monitoring and thus may be more convenient.
She concluded that these new agents have proven to be effective in various clinical trials. It is expected that they will be touted as favourable agents because of their predictable anticoagulant response, absence of food interactions, and limited drug interactions compared with warfarin.
Fabeha Pervez, Media Executive, Department of Public Affairs, Aga Khan University, Stadium Road, Karachi, on +92 21 3486 2925 or firstname.lastname@example.org