THERIGHTS OFTHE ANTIC OAGU THE DECALOGUE OF THE ESSENTIAL SERVICIES FOR AN EFFECTIVE AND SAFE ANTICOAGULATED PATIENTS THERAPY BUILD THE NETWORK OF SERVICIES FOR ANTICOAGULATED PATIENTS
1)INCREASE THE QUALITY OF THE ORAL ANTICOAGULATION THERAPY ACCESS POINTS Citizens in anticoagulation therapy are over one million, with upward trend. This therapy is life-saving and can currently make use of different drugs. Whatever the drug used, anticoagulation presents risks of bleeding and reduced protection. The risks increase if the therapy is conducted poorly and if it lacks healthcare services and medical performance needed for its quality. 2)ADJUST THE FREQUENCY OF PATIENT’S INR MEASUREMENTS Until a few years ago, the vitamin K antagonist (VKAs, Coumadin and Sintrom in Italy) have been the only oral anticoagulant drugs available and they are still the most AIPA NEWS
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used. The VKA oral anticoagulants require frequent laboratory monitoring and a consequent suitable adjustment of the daily dose. Insufficient quality of this monitoring activity (low level of time spent in the desired therapeutic range) reduces the efficiency and increases the risk of anticoagulation; therefore, patients are exposed to more thrombotic or bleeding complications.
3)IMPROVE PATIENTS’ AND FAMILY CAREGIVERS’ QUALITY OF LIFE Health services must provide to make available periodic INR test (essential for VKA) with modalities of access that favors the patients’ quality of life (and of their relatives) and with suitable quality of execution (laboratory or portable intstruments, subjected to quality control) reducing as much as possible the need of patient displacements (and of their relatives) and providing appropriate services to patients with limited mobility.
AVK drug is critical for safety and effectiveness of the therapy. This requires training and experience. Specialized medical centers, dedicated to the control of anticoagulated, are particularly suitable for this purpose. General Practitioners can play this activity after adequate specific training, with the use of computer tools to help in establishing dosages, and connection/ collaboration with specialized medical centres, territorially organized (network of services for anticoagulated patients).
5) ENSURE THE ANTICOAGULATED PATIENT’S RIGHT OF CHOICE Citizens in anticoagulant therapy with VKA should be given the right to choose who to entrust the monitoring and management of their own therapy. Patients have a right to require the retention of data relating to the Oral Anticoagulated Therapy requirements, at speciali-
4)ENSURING PERIODIC EDUCATION AND SERVICIES NETWORK FOR ANTICOAGULATED PATIENT Proper adjustment daily dose of 2
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