A nurse led clinic and computer decision support system for anticoagulation decisions was at least as effective as a hospital clinic.(Brief Article)(Statistical Data Included)

Fitzmaurice DA, Hobbs FD, Murray ET, et al. Oral anticoagulation management in primary care with the use of computerized decision support and near-patient testing: a randomized, controlled trial Arch Intern Med 2000 Aug 60:2343-8.

QUESTION: For patients who require oral anticoagulation, is a nurse led clinic that uses onsite blood testing and a computerised decision support system as effective as routine hospital care for maintaining appropriate international normalised ratios (INRs)?

Design

Randomised {allocation concealed}*, unblinded, controlled trial with 1 year of follow up.

Setting

9 of 21 potential general practices in Birmingham, UK.

Patients

224 adults (55% men) who were receiving warfarin. Follow up was 82%.

Intervention

122 patients were allocated to nurse …