34 Pa A Pilot Study Of Management Of Deep Vein Thrombosis (Dvt) In Primary Care Utilising Sub-Cutaneous Low Molecular Weight Heparin (Lmwh) With Near Patient Testing (Npt) And Computerised Decision Support (Dss) For Warfarin Management.

Conference: 
Author(s): 
DA Fitzmaurice, Research Associate, Department of General Practice, The Medical School, The University of Birmingham, UK. Ellen T Murray, FDR Hobbs, PE Rose.
Text: 
Introduction:
LMWH has been shown to be safe and effective for the treatment of DVT within secondary care. By combining LMWH with NPT and DSS for warfarin dosing it may be possible to treat uncomplicated DVT completely within the community. This study was designed to investigate the feasibility of managing patients with DVT in the primary care setting.
Method: All patients with suspected DVT will be recruited from 7 general practices with established warfarin clinics using NPT and DSS. All patients will receive subcutaneous injections of LMWH administered by practice nurse. Radiological diagnosis will be available within 72 hours. Warfarin therapy will be commenced on radiological confirmation of DVT. Patients with confirmed DVT will receive at least. 6 days LMWH therapy, and 3 months warfarin therapy.
Results: Data to be presented will include: 1. Patient acceptability, 2. Adverse effects; 3. The level of INR control; 4. Health economic assessment.
Discussion:
Acute DVTs managed in primary care would remove the necessity for hospital admission resulting in overall cost savings for the NHS, whilst having benefits in convenience and indirect costs to patients.
Literature: 
34 PA A PILOT STUDY OF MANAGEMENT OF DEEP VEIN THROMBOSIS (DVT) IN PRIMARY CARE UTILISING SUB-CUTANEOUS LOW MOLECULAR WEIGHT HEPARIN (LMWH) WITH NEAR PATIENT TESTING (NPT) AND COMPUTERISED DECISION SUPPORT (DSS) FOR WARFARIN MANAGEMENT.