Managing the effect of the Covid-19 lockdown on patients taking warfarin

This article has been double-blind peer reviewed

In this article…

• Why warfarin treatment can be difficult for patients and clinicians to manage

• The impact of Covid-19 lockdown on patients taking warfarin

• How anticoagulation services need to adapt to the pandemic

Key points

Open multimedia modal

Patients taking warfarin need regular blood tests to ensure they remain within a set therapeutic range

Warfarin’s narrow therapeutic index makes it difficult for some patients to remain within range

Patients’ ability to stay in range was reduced by the Covid-19 lockdown

This was more likely to increase the risk of bleeding rather than developing a clot

Patients should be informed of the variable nature of their results and factors that can influence them

Abstract

Warfarin is one of the most widely used anticoagulants in the UK. Patients taking warfarin need regular blood tests to ensure levels remain within therapeutic range. If patients fall below this range, they are at higher risk of developing a venous thromboembolism and if they go above this range, they are at greater risk of bleeding. Analysis of the effect of the first Covid-19 lockdown on patients taking warfarin showed patients spent less time in therapeutic range and were at greater risk of bleeding as result. A nursing strategy was developed to improve anticoagulation management in the event of any future Covid-19 restrictions. This included improving patient education, changes to clinic attendance and reviewing patients’ suitability for switching to a direct oral anticoagulant.