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Maria Stella Graziani

Deputy Director
Martina Zaninotto

Associate Editors
Ferruccio Ceriotti
Davide Giavarina
Bruna Lo Sasso
Giampaolo Merlini
Martina Montagnana
Andrea Mosca
Paola Pezzati
Rossella Tomaiuolo
Matteo Vidali

EIC Assistant
Francesco Busardò

International Advisory Board Khosrow Adeli Canada
Sergio Bernardini Italy
Marcello Ciaccio Italy
Eleftherios Diamandis Canada
Philippe Gillery France
Kjell Grankvist Sweden
Hans Jacobs The Netherlands
Eric Kilpatrick UK
Magdalena Krintus Poland
Giuseppe Lippi Italy
Mario Plebani Italy
Sverre Sandberg Norway
Ana-Maria Simundic Croatia
Tommaso Trenti Italy
Cas Weykamp The Netherlands
Maria Willrich USA
Paul Yip Canada

Biomedia srl
Via L. Temolo 4, 20126 Milano

Responsible Editor
Giuseppe Agosta

Editorial Secretary
Chiara Riva
Biomedia srl
Via L. Temolo 4, 20126 Milano
Tel. 0245498282


ISSN print: 0393 – 0564
ISSN digital: 0392- 7091

Articoli con TAG: terapia anticoagulante orale

Modello organizzativo di gestione decentrata della terapia anticoagulante orale nella ULSS 6 Euganea
Organisational model for the local management of oral anticoagulant therapy in the “ULSS 6 Euganea”.
<p><span style="color:#333333; font-family:arial,sans-serif; font-size:10.0pt">Introduction: Point of Care portable coagulometers (POCT-INR) allow to shift determination of prothrombin time</span> (PT-INR) from central laboratory to local health facilities. In a broad and complex territory, determining PT-INR in decentralized offices is a key objective for the monitoring of the therapy and patient&rsquo;s life quality improvement. Aim of the study is the description of the organizational model for decentralized management of patients in Oral Anticoagulant Therapy. Methods: starting from October 2020, a bidirectional connection was implemented between Laboratory Information System (LIS) of the Ospedali Riuniti Padova Sud &ldquo;Madre Teresa di Calcutta&rdquo; Monselice (Padova, Italy) and peripheral offices, where clinical data are collected and PT-INR determined by POCT-INR (by Coaguchek&reg; Roche Diagnostics, Germany). Results are sent in real time to central laboratory where data are validated and stored. Data can be consulted and downloaded like any other laboratory test. Results: the project involved 2 980 patients. Peripheral centres are located throughout the territory of ULSS 6 Euganea, with 81 POCT-INR instruments for around 60 000 determinations per year with an average of 7.4 INR measurement per patient. Around 2% of these INR showed a value &gt;5 (critical value) and have been immediately communicated by the POCT manager to the physician in charge of the therapy. For two patients with polycytemia vera it was impossible to have an INR value measured by the POCT because of the high value of the hematocrit and a venous blood collection was necessary. The POCT instruments analytical performances are verified by the POCT manager, using an internal quality control program; regular reports are sent to the pertinent local facility. Conclusions: the connection with LIS represents the project&rsquo;s focal point, allowing data storage, making them available at any time for any connected facility. This model simplifies the management of patients allowing easier access to the determination of PT-INR, with more constant therapy control and significant improvement of the patients&rsquo; quality of life without jeopardizing the patients&rsquo; safety.</p>
Biochimica Clinica ; 46(2) 134-140
Contributi Scientifici - Scientific Paper
La gestione del paziente in terapia anticoagulante orale in corso di pandemia: le soluzioni del Centro Emostasi e Trombosi di Savona
Monitoring of anticoagulant therapy during the COVID pandemic: the experience of the antithrombosis Centre in Savona (SV-Italy)
<p><span style="font-family:calibri,sans-serif; font-size:11.0pt">Introduction: the health emergency caused by the COVID-19 pandemic has forced health providers to rethink and reformulate patients&rsquo; care management, particularly during lockdown, in view of the need of stronger interactions between hospitals and local medical care with the aim of reducing the number of patients&rsquo; accesses to the hospitals. Patient under oral anticoagulant therapy, particularly those treated with antivitamin K drugs (AVK), need continuous therapy monitoring and drug dose adjustment, thus increasing their risk of possible SARS-CoV-2 exposure during the visits to the hospitals. The aim of this study is to illustrate, using appropriate indicators, the outcomes of an alternative clinical management of anticoagulated patients, adopting a new organizational model and an extended use of digital tools. Methods: a dedicated telephone number and a digital platform for therapy issuing were activated to maintain continuous patient surveillance and counselling activity. Specific indicators were: number of telephone calls received; number of digital therapy prescriptions; time in range (TTR) of AVK patients; number of major adverse events. Results: during the pandemic phase 10 215 telephone calls were received (with an increase of 200% compared to the pre-pandemic era). When compared to the values observed in the pre-pandemic period, the values of the indicators remained stable during the pandemic phase: TTR of AVK patients was 74% versus 74.6%; 22 minor and 2 major bleeding events were recorded versus 21 and 2 respectively. Discussion: the results obtained show, from the patient side, an optimal acceptance of the model proposed and, from the clinical side, the maintenance of the pre-pandemic quality standards of care</span></p>
Biochimica Clinica ; 46(3) 213-217
Contributi Scientifici - Scientific Papers