Warfarin Therapy Issues - Essay Example

Constructive Criticism to Warfarin Therapy Issues To KF In reviewing your question, how does warfarin therapy compared to other newer anti-coagulants, affect bleeding risks in older people in the United States, research shows that there is a tool that doctors use to assess who should be on Warfarin. The CHADS2 scoring system is the most commonly used testing system for initial patient review. Additionally, schemas are tools that determine the bleeding risks, as regards atrial fibrillation (AF) patients, but did not include other risk factors that might also be in place.

Therefore, a new schema, HAS_BLED, now is the most advanced tool for assessing bleeding issues, not only with AF, but those at risk for heart failure, diabetes, high blood pressure or hypertension, and blood clots (thromboembolisms) (Noonan & Hills, 2010). Researchers who developed this process were led by Dr. Gregory YH Lip at the University of Birmingham Center for Cardiovascular Science. He may have the most up-to-date processes right now for comparisons of similar drugs to Warfarin which have fewer problems with potential bleeding occurrences.

This would allow you to bypass research that may not have the latest information that you are requiring in comparative dosage. HAS-BLED is made up of the first letters to health issues that the schema addresses: Hypertension, Abnormal kidney and/or liver function, Stroke, Bleeding, Labile INR, Elderly, and Drugs and/or alcohol. Lip discovered during the research that the combined usage of both CHADS2 and HAS-BLED tools, could have prevented many of the bleeding issues found in previous cases.

The results of the combined testing would have shown that in the case of your mother, Lip would have known which other drugs on the market, would work better for her needs. This would be the true value of evidence-based practice, where research provides the answers that already verify the solution to an existing condition (Melnyk & Fineout-Overholt, 2011). In using the search question “how does warfarin therapy compare to other newer anticoagulants affect bleeding risks in older people in US,” another study was brought up that reflected a doctor’s experience with newer drugs, dabigatran and rivaroxaban, that differ in many ways from warfarin, although dabigatran has some history of stomach distress (Schulman & Crowther, 2012).

As the author suggests, doctors need to be mindful of the pharmacokinetics and action mechanisms of the drugs when considering whether to proscribe them to patients. The article is a well-researched overview of how he made his discoveries and applications and also has a full list of resources that would also be helpful for your research to obtain more data. The two resources referenced here provide a good starting point for your future research regarding your mother’s condition and how to create search terms as well (Melnyk & Fineout-Overholt, 2011).

Resources Melnyk, B.M., & Fineout-Overholt, E. (2011). Evidence-Based Practice in Nursing & Healthcare (2nd ed.). Baltimore, MD: Wolters Kluwer Health. Noonan, P., & Hills, M.T. (2010). New “HAS-BLED” Tool Identifies Those with Atrial Fibrillations at Risk for Bleeding From Coumadin or Warfarin. StopAFib.org Online. Retrieved from http://www.stopafib.org/newsitem.cfm/NEWSID/252/CHADS2%20and%20HAS-BLED%20assess%20%20Coumadin%20bleeding%20risk%20in%20atrial%20fibrillation/warfarin%20anticoagulant.

(Noonan & Hills, 2010) Schulman, S., & Crowther, M.A. (2012). How I Treat with Anticoagulants in 2012: New and Old Anticoagulants, and When and How to Switch. The American Society of Hematology and Blood Journal Online. Retrieved from http://bloodjournal.hematologylibrary.org/content/119/13/3016.full.