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Missed Doses
Posted by: David Malakoty ()
Date: 19 May, 2014 07:47AM


Just wondering if you could offer some advice on what we should do if a patient freely admits that they have missed a dose.

Is it better to adjust the weekly regime for the last week to demonstrate the missed dose or doses? Or would this only be advisable if the missed dose had been weekly since their last review.

Or would it be better to just not adjst the dosing regime and bring the patient back for review in a week and ensure that they take the medication as prescribed.

Thanks for any advice,


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Re: Missed Doses
Posted by: Colm Rafferty ()
Date: 19 May, 2014 08:05AM

Dear David,
In most scenarios where a patient has missed a dose it is best to not adjust the previous weekly total dose.

If a patient missed a dose in the past 72 hours and their INR is below the target range then best not to adjust the previous weekly range as we have a reason for the low INR.

If a patient has been missed a dose in past 48 hours yet the INR is higher end of normal or above the target range then best to bring them back in 1 week.

So your second recommendation would be the best.

Colm Rafferty

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