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Odd recall interval
Posted by: John Moon ()
Date: 27 July, 2010 11:10AM

A pt was tested this morning. INR of 1.2 (target range 2-3). This was the 4th low reading in a row. RAT recommended inc in warfarin plus ?compliance, ?resistance, all very sensible, but then gave a recall date of 4 weeks which in the circumstances is not so sensible. Our HCA doing the test referred it to a GP who overrode the RAT recommendation to bring the pt back sooner. Any ideas why 4 weeks recall was proposed with an unstable/unresponsive pt?

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Re: Odd recall interval
Posted by: C Rafferty ()
Date: 27 July, 2010 02:23PM

Dear John,
I have not come across this before.
Any low INR gives a review in 1-2 weeks.
Can you give me the previous 5 INR values, dates, warfarin doses, INR range for that patient and indication and treatment length.

I will enter the same data on a fictitious patient to see if I can reproduce.
RAT is always consistent in every scenario.

Can I also ask you to delete todays result by going to the previous values, and re-enter the INR yourself today to see what RAT outputs.

Regards
Colm Rafferty

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Re: Odd recall interval
Posted by: daniel khew ()
Date: 27 February, 2012 11:35AM

I have a patient on long term warfarin for TIA and cardiomypathy. her inr test is always in the normal therapeutic range(2-3) but the RAT system always asked for earlier rv like 1/52 and then has been ongoing for the last 3/12 even despite us overriding it and bringing the pt back every 4-6 weeks. Is there any reason for that and how can we adjust it? than you.
last 4 inr was 2.3 2.8 2.5 2.4(and always asking for 1/52 review)

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Re: Odd recall interval
Posted by: Colm Rafferty ()
Date: 27 February, 2012 11:47AM

Dear Daniel,

To the right of the INR input box , is a 'Weekly monitoring' checkbox.
Can you make sure this is not checked.
When this box is 'checked' the patient will always have a weekly review date.

Regards
Colm Rafferty

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Re: printing
Date: 28 March, 2012 08:20AM

Hi
Is it possible to print out a new instruction sheet for patient if the recall date has been ammended after the recommendations have been saved.
KHenderson

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Re: printing
Posted by: Colm Rafferty ()
Date: 28 March, 2012 08:57AM

Dear Kathyrn,
If you access the patient record, go to top menu, 'Database'. A submenu will appear. Choose 'Print current details'
This will print out the current dose regimen, though not the same as the regular printout, and does not give the review date.
The only other option, is to delete the the most recent INR/dose/review date and re-enter the INR, then amend review date and print

Regards
Colm Rafferty

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