Frequently asked questions Prev: Database utilities

Why is the review date sometimes less than 4 weeks when a normal INR is entered?
This is because in certain circumstances this would be inappropriate.
Example 1 :
If a patient has just started warfarin and any sample is within normal range in the first 6 weeks the review is 1 to 2 weeks to make sure that the patient is stabilized on treatment before extending reviews.

Example 2:
If an INR result is > 5.5 and warfarin has been stopped for a few days, but is in normal range in the follow up sample, review date is 1 to 2 weeks, again to make sure that the patient is stabilized before extending reviews.

Why is the review date sometimes greater than 1 week when an out of range INR is entered?
This is because the alteration in the warfarin dose is on a day within 72 hours of the next review. 
To allow for stabilization, the review is extended by 1 week.
Any adjustment in warfarin needs at least 72 hours before the effect can be measured.

How do I know who will be attending the INR clinic in the next few weeks?
When you click the icon, this will give a list of patients and their review date. Patients who are overdue will be at the top of list. This list is in date order. You can print out this list on the right hand side of prescription paper by clicking the print list button. 
To adjust this list go to setup. Click on the practice tab and adjust the display review dates for... to the number of weeks you want displayed. If you only want to see the next two weeks, then select 2 weeks. 
How can I alert the user if a patient has poor compliance or confused about dose?
This symbol can be used if you are suspicious that a patient is taking the incorrect dose or forgetting tablets. It is used as a visual reminder and is displayed lateral to the text box for entering the current INR.

To display this warning, within the patient record:

1. Click the history tab
2. Click the icon ->
3. Click on the poor compliance box
4. Click OK button

The symbol should then appear lateral to the text box for entering the current INR. It will appear each time the patient record is loaded. To remove it, simply click on the poor compliance box as before.

The scribble pad also allows you to put persistent pertinent information about the patient highly visible on screen.

How do I change a wrongly entered INR value?
If you have not saved an INR result for today then just click on today's INR and re-enter the correct value.

If you have already saved an incorrect INR:
1. Call up the patient details
2. Follow steps 1, 2 and 3 in the previous answer
3. Highlight the row of the most recent entry, 
4. Click the delete button. This row will disappear.
5. Click the OK button
6. Re-enter the correct INR and then click recommendations
Any text in the continuation notes for the previous recommendations based on the previously incorrect INR will be deleted.
Why should I select a day for the clinic?
This is to allocate a review date for the patient that is the appropriate day of the week. For example, if your clinic is on a Thursday and a patient arrives earlier, e.g., on the Tuesday, if the new review date is for 4 weeks from that Tuesday, the allocated date will be the Thursday of that week, not the Tuesday.

You may run your INR monitoring on an ad-hoc basis. In this case there is no need to allocate a day.
In the Setup screen, what is maximum review date for?
When a patient has a series of stable INRs, the review date is usually extended.

If 1 INR in range : Review in 4 weeks
If 2 INRs in range : Review in 6 weeks
If 3 INRs in range : Review in 8 weeks
If 4 INRs in range : Review in 10 weeks
If >=5 INRs in range : Review in 12 weeks

Can I copy the INR and warfarin recommendations to my clinical system?
Yes. If you go to the setup screen, you will see an option for 'Paste RAT recommendations to computer memory'. This will store the recommendations to the PC clipboard allowing you to paste into your clinical system. RAT does not directly link to the clinical system.

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    Please note RAT should only be used by health professionals familiar with warfarin management
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