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Predicate | Object |
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rdf:type | |
lifeskim:mentions | |
pubmed:issue |
3
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pubmed:dateCreated |
1997-12-18
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pubmed:abstractText |
With increasing work-loads in anticoagulant clinics different methods of service delivery need evaluation. The quality of anticoagulant control achieved by a nurse-practitioner using a computer decision-support system (CDSS) was compared with that achieved by trainee doctors without CDSS. Eighty-one out-patients (group A, therapeutic range 2-3) and 96 out-patients (group B, therapeutic range 3-4.5) were randomized to management by a nurse-practitioner or by trainee doctors (clinicians). Thirty-seven patients in group A and 50 patients in group B were randomized to be managed by the nurse-practitioner. In group A, patients in the nurse-practitioner group spent a longer time in the therapeutic range than those in the clinician group (60.7% compared with 51.6%). Dose suggestion acceptance in the nurse-practitioner group (88%) was higher compared with agreement between the CDSS and the clinicians (60%). In group B, patients in the clinician group spent a slightly longer time in the therapeutic range (70% compared with 67.6%). Acceptance of dose suggestion was lower in the nurse-practitioner group (67%) compared with agreement between the CDSS and the clinicians (73%). In conclusion, the CDSS can improve the quality of control of warfarin therapy by a nurse-practitioner over that by trainee doctors for the therapeutic range 2-3. Similar quality of control is achieved for the therapeutic range 3-4.5. The CDSS may be used by nurse-practitioners to achieve safe and effective anticoagulation in hospital-based or out-reach anticoagulant clinics.
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pubmed:language |
eng
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pubmed:journal | |
pubmed:citationSubset |
IM
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pubmed:chemical | |
pubmed:status |
MEDLINE
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pubmed:month |
Sep
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pubmed:issn |
0141-9854
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pubmed:author | |
pubmed:issnType |
Print
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pubmed:volume |
19
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pubmed:owner |
NLM
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pubmed:authorsComplete |
Y
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pubmed:pagination |
203-7
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pubmed:dateRevised |
2006-11-15
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pubmed:meshHeading |
pubmed-meshheading:9352146-Administration, Oral,
pubmed-meshheading:9352146-Adolescent,
pubmed-meshheading:9352146-Adult,
pubmed-meshheading:9352146-Aged,
pubmed-meshheading:9352146-Aged, 80 and over,
pubmed-meshheading:9352146-Anticoagulants,
pubmed-meshheading:9352146-Decision Making, Computer-Assisted,
pubmed-meshheading:9352146-Female,
pubmed-meshheading:9352146-Humans,
pubmed-meshheading:9352146-Male,
pubmed-meshheading:9352146-Middle Aged,
pubmed-meshheading:9352146-Nurse Practitioners,
pubmed-meshheading:9352146-Physicians,
pubmed-meshheading:9352146-Quality Assurance, Health Care
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pubmed:year |
1997
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pubmed:articleTitle |
Comparison of oral anticoagulant control by a nurse-practitioner using a computer decision-support system with that by clinicians.
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pubmed:affiliation |
Clinical and Academic Department of Cardiovascular Medicine, Whittington Hospital, London, UK.
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pubmed:publicationType |
Journal Article,
Clinical Trial,
Comparative Study,
Randomized Controlled Trial,
Research Support, Non-U.S. Gov't
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