Appropriate time of thrombophilia testing related to oral anticoagulant therapy: are recommended guidelines followed (CROSBI ID 636077)
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Podaci o odgovornosti
Margetić Sandra ; Getaldić Biserka ; Ćelap Ivana ; Vrkić Nada
engleski
Appropriate time of thrombophilia testing related to oral anticoagulant therapy: are recommended guidelines followed
Background: The appropriate time of testing related to oral anticoagulant therapy (OAT) is one of the crucial preanalytical variables for thrombophilia investigation since many of these tests are affected by this therapy. In order to gain insight into physicians ordering practices, we performed a retrospective analysis of consecutive thrombophilia tests ordered during the 10-month period. Materials and methods: The study included lupus anticoagulant (LA) investigation and functional assays for protein C (PC), protein (PS) and resistance to activated protein C (APCR), using commercially available coagulation methods (Siemens, Germany). Results: A total number of tests performed was as follows: 853 (LA), 608 (PC), 443 (PS) and 540 (APCR.) Proportions of positive results for each test were: LA = 35/853 (4.1%), PC = 28/608 (4.6%), PS = 50/443 (11.3%) and APCR = 52/540 (9.6%). Of all positive test results, 10/35 (28.6%) for LA, 20/28 (71.4%) for PC, 22/50 (44%) for PS and 3/52 (5.8%) for APCR were attributable to OAT, thus representing false- positive results that could have considerable implications for patients. Conclusions: Our findings suggest the appropriate time of testing related to OAT to be simply overlooked by clinicians managing patients with thrombosis, thus resulting with a huge waste of resources with concomitant high likelihood of false-positive test results. Our findings indicate that thrombophilia testing in patients on OAT still occurs frequently in clinical practice despite recommended guidelines. The net effect of such testing is likely to be more detrimental than beneficial for the patient. On the basis of our results, it is obvious that laboratories need to take a more substantial role in the thrombophilia investigation process than just providing doctors with numbers. The corrective actions should include ongoing education of clinicians and reject testing in patients on OAT since it would be more rational, cost-effective and beneficial for patients.
thrombophilia testing; oral anticoagulant therapy; preanalytical variable
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Podaci o prilogu
A35-A35.
2013.
nije evidentirano
objavljeno
Podaci o matičnoj publikaciji
Šimundić Ana-Maria
Zagreb: Hrvatsko društvo za medicinsku biokemiju i laboratorijsku medicinu/Medicinska naklada
1330-0962
Podaci o skupu
2nd EFLM-BD European Conference on Preanalytical Phase: Preanalytical quality improvement – in quality we trust
poster
01.03.2013-02.03.2013
Zagreb, Hrvatska
Povezanost rada
Kliničke medicinske znanosti, Farmacija