Dataset Information

Outcomes of anticoagulation therapy in patients with mental health conditions.

ABSTRACT:

Background

Patients with mental health conditions (MHCs) experience poor anticoagulation control when using warfarin, but we have limited knowledge of the association between specific mental illness and warfarin treatment outcomes.

Objective

To examine the relationship between the severity of MHCs and outcomes of anticoagulation therapy.

Design

Retrospective cohort analysis.

Participants

We studied 103,897 patients on warfarin for 6 or more months cared for by the Veterans Health Administration during fiscal years 2007-2008. We identified 28,216 patients with MHCs using ICD-9 codes: anxiety disorders, bipolar disorder, depression, post-traumatic stress disorder, schizophrenia, and other psychotic disorders.

Main measures

Outcomes included anticoagulation control, as measured by percent time in the therapeutic range (TTR), as well as major hemorrhage. Predictors included different categories of MHC, Global Assessment of Functioning (GAF) scores, and psychiatric hospitalizations.

Key results

Patients with bipolar disorder, depression, and other psychotic disorders experienced TTR decreases of 2.63 %, 2.26 %, and 2.92 %, respectively (p?ConclusionPatients with specific MHCs (bipolar disorder, depression, and other psychotic disorders) experienced slightly worse anticoagulation control. Patients with any MHC had a slightly increased hazard for major hemorrhage, but the magnitude of this difference is unlikely to be clinically significant. Overall, our results suggest that appropriately selected patients with MHCs can safely receive therapy with warfarin.

SUBMITTER: Paradise HT

PROVIDER: S-EPMC4026501 | biostudies-literature | 2014 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Outcomes of anticoagulation therapy in patients with mental health conditions.

Paradise Helen T HT Berlowitz Dan R DR Ozonoff Al A Miller Donald R DR Hylek Elaine M EM Ash Arlene S AS Jasuja Guneet K GK Zhao Shibei S Reisman Joel I JI Rose Adam J AJ

Journal of general internal medicine 20140219 6

<h4>Background</h4>Patients with mental health conditions (MHCs) experience poor anticoagulation control when using warfarin, but we have limited knowledge of the association between specific mental illness and warfarin treatment outcomes.<h4>Objective</h4>To examine the relationship between the severity of MHCs and outcomes of anticoagulation therapy.<h4>Design</h4>Retrospective cohort analysis.<h4>Participants</h4>We studied 103,897 patients on warfarin for 6 or more months cared for by the Ve ...[more]

PMID: 24549520

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Dataset Information

Outcomes of anticoagulation therapy in patients with mental health conditions.

Background

Objective

Design

Participants

Main measures

Key results

Publications

Outcomes of anticoagulation therapy in patients with mental health conditions.

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