Skip Navigation



European Heart Journal Advance Access published online on May 25, 2005
European Heart Journal, doi:10.1093/eurheartj/ehi327
This Article
Right arrow Full Text (Rapid PDF)
Right arrow All Versions of this Article:
26/20/2159    most recent
ehi327v1
Right arrow E-letters: Submit a response
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Claes, N.
Right arrow Articles by Van Loon, H.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Claes, N.
Right arrow Articles by Van Loon, H.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

European Heart Journal © The European Society of Cardiology 2005; all rights reserved
Received December 28, 2004
Revised March 14, 2005
Accepted April 13, 2005

Clinical research

The Belgian Improvement Study on Oral Anticoagulation Therapy: a randomized clinical trial

Neree Claes 1*, Frank Buntinx 1, Johan Vijgen 2, Jef Arnout 3, Jos Vermylen 3, Steffen Fieuws 4, and Herman Van Loon 1

1 Department of General Practice, Catholic University Leuven, Kapucijnenvoer, 33 Blok J, B-3000 Leuven, Leuven, Belgium
2 Department of Cardiology, Virga Jesse hospital Hasselt, Hasselt, Belgium
3 Centre for Molecular en Vascular Biology, Catholic University Leuven, Leuven, Belgium
4 Center for Biostatistics, Catholic University Leuven, Leuven, Belgium

* To whom correspondence should be addressed.
Neree Claes, E-mail: neree.claes{at}med.kuleuven.ac.be


  Abstract

Aims In Belgium, general practitioners (GPs) mainly manage oral anticoagulation therapy. To improve the quality of oral anticoagulation management by GPs and to compare different models and interventions, a randomized clinical trial was performed.

Methods and results Stratified randomization divided 66 GP-practices into four groups. A 6-month retrospective analysis assessed the baseline quality. In the prospective study, each group received education on oral anticoagulation, anticoagulation files, and patient information booklets (groups A, B, C, and D). Group B additionally received feedback every 2 months on their anticoagulation performance; group C determined the international normalized ratio (INR) with a CoaguChek device in the doctor's office or at the patient's home; and group D received Dawn AC computer assisted advice for adapting oral anticoagulation. For the different groups, the time spent in target INR range (Rosendaal's method) and adverse events related to anticoagulation were determined and compared with the same quality indicators at baseline. There was a significant increase in per cent of time within 0.5 INR from target, from 49.5% at baseline to 60% after implementing the different interventions. However, neither the per cent in target range nor the event rates differed among the four groups.

Conclusion The interventions significantly improved the quality of management of oral anticoagulation by Belgian GPs, mainly as a result of an education and support programme.

Keywords: Oral anticoagulation; General practitioner; Quality improvement; Randomized clinical trial.
Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 CirculationHome page
S. J. Connolly, J. Eikelboom, M. O'Donnell, J. Pogue, and S. Yusuf
Challenges of Establishing New Antithrombotic Therapies in Atrial Fibrillation
Circulation, July 24, 2007; 116(4): 449 - 455.
[Full Text] [PDF]

Home page
 Eur Heart JHome page
A. Katona and L. Mark
The Belgian Improvement Study in Oral Anticoagulant Therapy: a randomized clinical trial
Eur. Heart J., June 1, 2006; 27(11): 1382 - 1382.
[Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.