A Monitoring List for Oral Anticoagulation Case Management in Primary Care
DOI: 10.3238/zfa.2013.0165-0171german translation / full article
Background: Oral anticoagulation (OAC) with coumarin derivatives or new oral anticoagulants has been shown to be highly effective in preventing thromboembolic complications. However, monitoring, documentation and patient decision making in OAC treatment still have potential for improvement. The aim of this paper is to present the Coagulation-Monitoring-List (CoMoL), for monitoring patients on long-term antithrombotic treatment in family practices. The CoMoL was developed in the cluster-randomized PICANT-trial (Primary Care Management for Optimized Antithrombotic Treatment).
Methods: The CoMoL was developed in two steps: 1. Structure and content: based on monitoring lists used in other case management studies, literature research for evidence-based anticoagulation-treatment guidelines. 2. Practicability and feasibility: practice test.
Results: The CoMoL consists of six sections to assess the clinical diagnosis and the patient’s behavior. The severity of the situation is coded by a traffic light system (red, yellow, green) to enable the family practitioner and health care assistant to quickly assess the need for medical intervention and provide structured care.
Conclusions: The CoMoL can be used to help optimizing antithrombotic treatment in primary care. Experiences gained from the PICANT-trial and previous case management studies will help in the development of monitoring-instruments for other chronic illnesses.