| Abstract |
Warfarin is widely used around the world for the prevention and treatment of thrombosis and
venothromboembolism. Consequently, anticoagulation is monitored by measurement of the
international normalized ratio (INR), and warfarin dose is adjusted to maintain the INR within a target
range, between 2 and 3 for most patients. Despite its efficacy, warfarin has many shortcomings. One
of the drawbacks of warfarin use is the complexity of its dosing. This is due to
the ability of warfarin to interact with many commonly use drugs, herbs, lifestyle changes and foods,
which subsequently will augment or lessen its anticoagulation effects. This makes it harder for
healthcare providers to pinpoint the correct dose of warfarin for individual patients and increased the
risk of getting bleeding and thrombosis. Calculating the precise warfarin dosage during consultations
with patients is time consuming as the dosage needs to be counted weekly and must be tallied with
the changes of INR. Furthermore, there is still a trend among healthcare providers in Malaysia to
adjust warfarin doses based on daily dose adjustment and not weekly dose adjustment. This
necessitates a need for the calculations proposed by the MTAC Warfarin Protocol to be more
convenient and accessible. |