Naslov
Appropriate time of thrombophilia testing related to oral anticoagulant therapy: are recommended guidelines followed

Autori
Margetić Sandra ; Getaldić Biserka ; Ćelap Ivana ; Vrkić Nada

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Biochemia Medica / Šimundić Ana-Maria - Zagreb : Hrvatsko društvo za medicinsku biokemiju i laboratorijsku medicinu/Medicinska naklada, 2013, A35-A35

Skup
2nd EFLM-BD European Conference on Preanalytical Phase: Preanalytical quality improvement – in quality we trust

Mjesto i datum
Zagreb, Hrvatska, 01.03.2013. - 03.03.2013

Vrsta sudjelovanja
Poster

Vrsta recenzije
Nije recenziran

Ključne riječi
thrombophilia testing; oral anticoagulant therapy; preanalytical variable

Sažetak
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.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti, Farmacija

POVEZANOST RADA