A team-based approach to warfarin management in long term care: A feasibility study of the MEDeINR electronic decision support system
Background Previous studies in long-term care (LTC) have demonstrated that warfarin management is suboptimal with preventable adverse events often occurring as a result of poor International Normalized Ratio (INR) control. To assist LTC teams with the challenge of maintaining residents on warfarin i...
Saved in:
| Published in: | BMC geriatrics Vol. 10; no. 1; p. 38 |
|---|---|
| Main Authors: | , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
London
BioMed Central
10.06.2010
BioMed Central Ltd BMC |
| Subjects: | |
| ISSN: | 1471-2318, 1471-2318 |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Abstract | Background
Previous studies in long-term care (LTC) have demonstrated that warfarin management is suboptimal with preventable adverse events often occurring as a result of poor International Normalized Ratio (INR) control. To assist LTC teams with the challenge of maintaining residents on warfarin in the therapeutic range (INR of 2.0 to 3.0), we developed an electronic decision support system that was based on a validated algorithm for warfarin dosing. We evaluated the MEDeINR system in a pre-post implementation design by examining the impact on INR control, testing frequency, and experiences of staff in using the system.
Methods
For this feasibility study, we piloted the MEDeINR system in six LTC homes in Ontario, Canada. All128 residents (without a prosthetic valve) who were taking warfarin were included. Three-months of INR data prior to MEDeINR was collected via a retrospective chart audit, and three-months of INR data after implementation of MEDeINR was captured in the central computer database. The primary outcomes compared in a pre-post design were time in therapeutic range (TTR) and time in sub/supratherapeutic ranges based on all INR measures for every resident on warfarin. Secondary measures included the number of monthly INR tests/resident and survey/focus-group feedback from the LTC teams.
Results
LTC homes in our study had TTR's that were higher than past reports prior to the intervention. Overall, the TTR increased during the MEDeINR phase (65 to 69%), but was only significantly increased for one home (62% to 71%, p < 0.05). The percentage of time in supratherapeutic decreased from 14% to 11%, p = 0.08); there was little change for the subtherapeutic range (21% to 20%, p = 0.66). Overall, the average number of INR tests/30 days decreased from 4.2 to 3.1 (p < 0.0001) per resident after implementation of MEDeINR. Feedback received from LTC clinicians and staff was that the program decreased the work-load, improved confidence in management and decisions, and was generally easy to use.
Conclusion
Although LTC homes in our sample had TTR's that were relatively high prior to the intervention, the MEDeINR program represented a useful tool to promote optimal TTR, decrease INR venipunctures, streamline processes, and increase nurse and physician confidence around warfarin management. We have demonstrated that MEDeINR was a practical, usable clinical information system that can be incorporated into the LTC environment. |
|---|---|
| AbstractList | Previous studies in long-term care (LTC) have demonstrated that warfarin management is suboptimal with preventable adverse events often occurring as a result of poor International Normalized Ratio (INR) control. To assist LTC teams with the challenge of maintaining residents on warfarin in the therapeutic range (INR of 2.0 to 3.0), we developed an electronic decision support system that was based on a validated algorithm for warfarin dosing. We evaluated the MEDeINR system in a pre-post implementation design by examining the impact on INR control, testing frequency, and experiences of staff in using the system. For this feasibility study, we piloted the MEDeINR system in six LTC homes in Ontario, Canada. All128 residents (without a prosthetic valve) who were taking warfarin were included. Three-months of INR data prior to MEDeINR was collected via a retrospective chart audit, and three-months of INR data after implementation of MEDeINR was captured in the central computer database. The primary outcomes compared in a pre-post design were time in therapeutic range (TTR) and time in sub/supratherapeutic ranges based on all INR measures for every resident on warfarin. Secondary measures included the number of monthly INR tests/resident and survey/focus-group feedback from the LTC teams. LTC homes in our study had TTR's that were higher than past reports prior to the intervention. Overall, the TTR increased during the MEDeINR phase (65 to 69%), but was only significantly increased for one home (62% to 71%, p [less than] 0.05). The percentage of time in supratherapeutic decreased from 14% to 11%, p = 0.08); there was little change for the subtherapeutic range (21% to 20%, p = 0.66). Overall, the average number of INR tests/30 days decreased from 4.2 to 3.1 (p [less than] 0.0001) per resident after implementation of MEDeINR. Feedback received from LTC clinicians and staff was that the program decreased the work-load, improved confidence in management and decisions, and was generally easy to use. Although LTC homes in our sample had TTR's that were relatively high prior to the intervention, the MEDeINR program represented a useful tool to promote optimal TTR, decrease INR venipunctures, streamline processes, and increase nurse and physician confidence around warfarin management. We have demonstrated that MEDeINR was a practical, usable clinical information system that can be incorporated into the LTC environment. Background Previous studies in long-term care (LTC) have demonstrated that warfarin management is suboptimal with preventable adverse events often occurring as a result of poor International Normalized Ratio (INR) control. To assist LTC teams with the challenge of maintaining residents on warfarin in the therapeutic range (INR of 2.0 to 3.0), we developed an electronic decision support system that was based on a validated algorithm for warfarin dosing. We evaluated the MEDeINR system in a pre-post implementation design by examining the impact on INR control, testing frequency, and experiences of staff in using the system. Methods For this feasibility study, we piloted the MEDeINR system in six LTC homes in Ontario, Canada. All128 residents (without a prosthetic valve) who were taking warfarin were included. Three-months of INR data prior to MEDeINR was collected via a retrospective chart audit, and three-months of INR data after implementation of MEDeINR was captured in the central computer database. The primary outcomes compared in a pre-post design were time in therapeutic range (TTR) and time in sub/supratherapeutic ranges based on all INR measures for every resident on warfarin. Secondary measures included the number of monthly INR tests/resident and survey/focus-group feedback from the LTC teams. Results LTC homes in our study had TTR's that were higher than past reports prior to the intervention. Overall, the TTR increased during the MEDeINR phase (65 to 69%), but was only significantly increased for one home (62% to 71%, p [less than] 0.05). The percentage of time in supratherapeutic decreased from 14% to 11%, p = 0.08); there was little change for the subtherapeutic range (21% to 20%, p = 0.66). Overall, the average number of INR tests/30 days decreased from 4.2 to 3.1 (p [less than] 0.0001) per resident after implementation of MEDeINR. Feedback received from LTC clinicians and staff was that the program decreased the work-load, improved confidence in management and decisions, and was generally easy to use. Conclusion Although LTC homes in our sample had TTR's that were relatively high prior to the intervention, the MEDeINR program represented a useful tool to promote optimal TTR, decrease INR venipunctures, streamline processes, and increase nurse and physician confidence around warfarin management. We have demonstrated that MEDeINR was a practical, usable clinical information system that can be incorporated into the LTC environment. Background Previous studies in long-term care (LTC) have demonstrated that warfarin management is suboptimal with preventable adverse events often occurring as a result of poor International Normalized Ratio (INR) control. To assist LTC teams with the challenge of maintaining residents on warfarin in the therapeutic range (INR of 2.0 to 3.0), we developed an electronic decision support system that was based on a validated algorithm for warfarin dosing. We evaluated the MEDeINR system in a pre-post implementation design by examining the impact on INR control, testing frequency, and experiences of staff in using the system. Methods For this feasibility study, we piloted the MEDeINR system in six LTC homes in Ontario, Canada. All128 residents (without a prosthetic valve) who were taking warfarin were included. Three-months of INR data prior to MEDeINR was collected via a retrospective chart audit, and three-months of INR data after implementation of MEDeINR was captured in the central computer database. The primary outcomes compared in a pre-post design were time in therapeutic range (TTR) and time in sub/supratherapeutic ranges based on all INR measures for every resident on warfarin. Secondary measures included the number of monthly INR tests/resident and survey/focus-group feedback from the LTC teams. Results LTC homes in our study had TTR's that were higher than past reports prior to the intervention. Overall, the TTR increased during the MEDeINR phase (65 to 69%), but was only significantly increased for one home (62% to 71%, p < 0.05). The percentage of time in supratherapeutic decreased from 14% to 11%, p = 0.08); there was little change for the subtherapeutic range (21% to 20%, p = 0.66). Overall, the average number of INR tests/30 days decreased from 4.2 to 3.1 (p < 0.0001) per resident after implementation of MEDeINR. Feedback received from LTC clinicians and staff was that the program decreased the work-load, improved confidence in management and decisions, and was generally easy to use. Conclusion Although LTC homes in our sample had TTR's that were relatively high prior to the intervention, the MEDeINR program represented a useful tool to promote optimal TTR, decrease INR venipunctures, streamline processes, and increase nurse and physician confidence around warfarin management. We have demonstrated that MEDeINR was a practical, usable clinical information system that can be incorporated into the LTC environment. Abstract Background Previous studies in long-term care (LTC) have demonstrated that warfarin management is suboptimal with preventable adverse events often occurring as a result of poor International Normalized Ratio (INR) control. To assist LTC teams with the challenge of maintaining residents on warfarin in the therapeutic range (INR of 2.0 to 3.0), we developed an electronic decision support system that was based on a validated algorithm for warfarin dosing. We evaluated the MEDeINR system in a pre-post implementation design by examining the impact on INR control, testing frequency, and experiences of staff in using the system. Methods For this feasibility study, we piloted the MEDeINR system in six LTC homes in Ontario, Canada. All128 residents (without a prosthetic valve) who were taking warfarin were included. Three-months of INR data prior to MEDeINR was collected via a retrospective chart audit, and three-months of INR data after implementation of MEDeINR was captured in the central computer database. The primary outcomes compared in a pre-post design were time in therapeutic range (TTR) and time in sub/supratherapeutic ranges based on all INR measures for every resident on warfarin. Secondary measures included the number of monthly INR tests/resident and survey/focus-group feedback from the LTC teams. Results LTC homes in our study had TTR's that were higher than past reports prior to the intervention. Overall, the TTR increased during the MEDeINR phase (65 to 69%), but was only significantly increased for one home (62% to 71%, p < 0.05). The percentage of time in supratherapeutic decreased from 14% to 11%, p = 0.08); there was little change for the subtherapeutic range (21% to 20%, p = 0.66). Overall, the average number of INR tests/30 days decreased from 4.2 to 3.1 (p < 0.0001) per resident after implementation of MEDeINR. Feedback received from LTC clinicians and staff was that the program decreased the work-load, improved confidence in management and decisions, and was generally easy to use. Conclusion Although LTC homes in our sample had TTR's that were relatively high prior to the intervention, the MEDeINR program represented a useful tool to promote optimal TTR, decrease INR venipunctures, streamline processes, and increase nurse and physician confidence around warfarin management. We have demonstrated that MEDeINR was a practical, usable clinical information system that can be incorporated into the LTC environment. Previous studies in long-term care (LTC) have demonstrated that warfarin management is suboptimal with preventable adverse events often occurring as a result of poor International Normalized Ratio (INR) control. To assist LTC teams with the challenge of maintaining residents on warfarin in the therapeutic range (INR of 2.0 to 3.0), we developed an electronic decision support system that was based on a validated algorithm for warfarin dosing. We evaluated the MEDeINR system in a pre-post implementation design by examining the impact on INR control, testing frequency, and experiences of staff in using the system. For this feasibility study, we piloted the MEDeINR system in six LTC homes in Ontario, Canada. All128 residents (without a prosthetic valve) who were taking warfarin were included. Three-months of INR data prior to MEDeINR was collected via a retrospective chart audit, and three-months of INR data after implementation of MEDeINR was captured in the central computer database. The primary outcomes compared in a pre-post design were time in therapeutic range (TTR) and time in sub/supratherapeutic ranges based on all INR measures for every resident on warfarin. Secondary measures included the number of monthly INR tests/resident and survey/focus-group feedback from the LTC teams. LTC homes in our study had TTR's that were higher than past reports prior to the intervention. Overall, the TTR increased during the MEDeINR phase (65 to 69%), but was only significantly increased for one home (62% to 71%, p < 0.05). The percentage of time in supratherapeutic decreased from 14% to 11%, p = 0.08); there was little change for the subtherapeutic range (21% to 20%, p = 0.66). Overall, the average number of INR tests/30 days decreased from 4.2 to 3.1 (p < 0.0001) per resident after implementation of MEDeINR. Feedback received from LTC clinicians and staff was that the program decreased the work-load, improved confidence in management and decisions, and was generally easy to use. Although LTC homes in our sample had TTR's that were relatively high prior to the intervention, the MEDeINR program represented a useful tool to promote optimal TTR, decrease INR venipunctures, streamline processes, and increase nurse and physician confidence around warfarin management. We have demonstrated that MEDeINR was a practical, usable clinical information system that can be incorporated into the LTC environment. Previous studies in long-term care (LTC) have demonstrated that warfarin management is suboptimal with preventable adverse events often occurring as a result of poor International Normalized Ratio (INR) control. To assist LTC teams with the challenge of maintaining residents on warfarin in the therapeutic range (INR of 2.0 to 3.0), we developed an electronic decision support system that was based on a validated algorithm for warfarin dosing. We evaluated the MEDeINR system in a pre-post implementation design by examining the impact on INR control, testing frequency, and experiences of staff in using the system.BACKGROUNDPrevious studies in long-term care (LTC) have demonstrated that warfarin management is suboptimal with preventable adverse events often occurring as a result of poor International Normalized Ratio (INR) control. To assist LTC teams with the challenge of maintaining residents on warfarin in the therapeutic range (INR of 2.0 to 3.0), we developed an electronic decision support system that was based on a validated algorithm for warfarin dosing. We evaluated the MEDeINR system in a pre-post implementation design by examining the impact on INR control, testing frequency, and experiences of staff in using the system.For this feasibility study, we piloted the MEDeINR system in six LTC homes in Ontario, Canada. All128 residents (without a prosthetic valve) who were taking warfarin were included. Three-months of INR data prior to MEDeINR was collected via a retrospective chart audit, and three-months of INR data after implementation of MEDeINR was captured in the central computer database. The primary outcomes compared in a pre-post design were time in therapeutic range (TTR) and time in sub/supratherapeutic ranges based on all INR measures for every resident on warfarin. Secondary measures included the number of monthly INR tests/resident and survey/focus-group feedback from the LTC teams.METHODSFor this feasibility study, we piloted the MEDeINR system in six LTC homes in Ontario, Canada. All128 residents (without a prosthetic valve) who were taking warfarin were included. Three-months of INR data prior to MEDeINR was collected via a retrospective chart audit, and three-months of INR data after implementation of MEDeINR was captured in the central computer database. The primary outcomes compared in a pre-post design were time in therapeutic range (TTR) and time in sub/supratherapeutic ranges based on all INR measures for every resident on warfarin. Secondary measures included the number of monthly INR tests/resident and survey/focus-group feedback from the LTC teams.LTC homes in our study had TTR's that were higher than past reports prior to the intervention. Overall, the TTR increased during the MEDeINR phase (65 to 69%), but was only significantly increased for one home (62% to 71%, p < 0.05). The percentage of time in supratherapeutic decreased from 14% to 11%, p = 0.08); there was little change for the subtherapeutic range (21% to 20%, p = 0.66). Overall, the average number of INR tests/30 days decreased from 4.2 to 3.1 (p < 0.0001) per resident after implementation of MEDeINR. Feedback received from LTC clinicians and staff was that the program decreased the work-load, improved confidence in management and decisions, and was generally easy to use.RESULTSLTC homes in our study had TTR's that were higher than past reports prior to the intervention. Overall, the TTR increased during the MEDeINR phase (65 to 69%), but was only significantly increased for one home (62% to 71%, p < 0.05). The percentage of time in supratherapeutic decreased from 14% to 11%, p = 0.08); there was little change for the subtherapeutic range (21% to 20%, p = 0.66). Overall, the average number of INR tests/30 days decreased from 4.2 to 3.1 (p < 0.0001) per resident after implementation of MEDeINR. Feedback received from LTC clinicians and staff was that the program decreased the work-load, improved confidence in management and decisions, and was generally easy to use.Although LTC homes in our sample had TTR's that were relatively high prior to the intervention, the MEDeINR program represented a useful tool to promote optimal TTR, decrease INR venipunctures, streamline processes, and increase nurse and physician confidence around warfarin management. We have demonstrated that MEDeINR was a practical, usable clinical information system that can be incorporated into the LTC environment.CONCLUSIONAlthough LTC homes in our sample had TTR's that were relatively high prior to the intervention, the MEDeINR program represented a useful tool to promote optimal TTR, decrease INR venipunctures, streamline processes, and increase nurse and physician confidence around warfarin management. We have demonstrated that MEDeINR was a practical, usable clinical information system that can be incorporated into the LTC environment. |
| ArticleNumber | 38 |
| Audience | Academic |
| Author | Stroud, Jacqueline B Papaioannou, Alexandra Kennedy, Courtney C Crowther, Mark A Wang, Luqi Dolovich, Lisa Campbell, Glenda |
| AuthorAffiliation | 1 Department of Medicine, McMaster University, 1280 Main Street West, Hamilton, L8N 3Z5, Canada 3 Thrombosis Research, St. Joseph's Healthcare, 50 Charlton Avenue East, Hamilton, L8N 4A6, Canada 2 Medical Pharmacies Group Inc., 590 Granite Court, Pickering, L1W 3X6, Canada 4 Department of Family Medicine, McMaster University, 1280 Main Street West, Hamilton, L8N 3Z5, Canada |
| AuthorAffiliation_xml | – name: 4 Department of Family Medicine, McMaster University, 1280 Main Street West, Hamilton, L8N 3Z5, Canada – name: 1 Department of Medicine, McMaster University, 1280 Main Street West, Hamilton, L8N 3Z5, Canada – name: 2 Medical Pharmacies Group Inc., 590 Granite Court, Pickering, L1W 3X6, Canada – name: 3 Thrombosis Research, St. Joseph's Healthcare, 50 Charlton Avenue East, Hamilton, L8N 4A6, Canada |
| Author_xml | – sequence: 1 givenname: Alexandra surname: Papaioannou fullname: Papaioannou, Alexandra email: papaioannou@hhsc.ca organization: Department of Medicine, McMaster University – sequence: 2 givenname: Courtney C surname: Kennedy fullname: Kennedy, Courtney C organization: Department of Medicine, McMaster University – sequence: 3 givenname: Glenda surname: Campbell fullname: Campbell, Glenda organization: Medical Pharmacies Group Inc – sequence: 4 givenname: Jacqueline B surname: Stroud fullname: Stroud, Jacqueline B organization: Medical Pharmacies Group Inc – sequence: 5 givenname: Luqi surname: Wang fullname: Wang, Luqi organization: Thrombosis Research, St. Joseph's Healthcare – sequence: 6 givenname: Lisa surname: Dolovich fullname: Dolovich, Lisa organization: Department of Family Medicine, McMaster University – sequence: 7 givenname: Mark A surname: Crowther fullname: Crowther, Mark A organization: Department of Medicine, McMaster University |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/20537178$$D View this record in MEDLINE/PubMed |
| BookMark | eNp9Uk1v1DAQjVAR_YAzN2SJA6e0duJ8cUBalQIrFZAQnC1nPMl6ldjBdkD7A_jfOGxZdREgH-wZv_dm7HnnyYmxBpPkKaOXjNXlFeMVS7Oc1SmjaV4_SM4OmZN759Pk3Pstpayqs_JRcprRIq9icJb8WJGAckxb6VEROU3OStiQYMl36TrptCGjNLLHEU0gMRqs6SPFjQSkw5dkRTqUXrd60GFHfJjVjtiOhA2S9zevcf3hE8EBIThrNBCFoL22hvh5mqwLxO98wPFx8rCTg8cnd_tF8uXNzefrd-ntx7fr69VtCkVZhrSQDKClDQXFMlUyrBrsuGwZFpwr2jZQIueFhJLmqumysm4rVnSQVTxnkLH8IlnvdZWVWzE5PUq3E1Zq8SthXS-kCxoGFEpRaEpGK8YzTou6hbaJGmopAKVUUevVXmua2xEVxP9xcjgSPb4xeiN6-01kDc14nUWBF3cCzn6d0Qcxag84DNKgnb2o8rxoOKc8Ip_vkb2MnWnT2SgIC1qs4nhzXjSsiajLv6DiUjhqiL7pdMwfEZ7df8Gh9d_uiICrPQCc9d5hd4AwKhb_icVhYnHYkskXRvEHA3SQIU489qKH__DonudjBdOjE1s7OxO98E_KT7Vx7Ng |
| CitedBy_id | crossref_primary_10_1002_jcph_1699 crossref_primary_10_1080_10408363_2020_1720591 crossref_primary_10_1186_1471_2318_12_14 crossref_primary_10_1016_j_jhqr_2024_06_004 crossref_primary_10_1186_s12913_017_2330_0 crossref_primary_10_1007_s00391_011_0268_0 crossref_primary_10_1517_14656566_2013_747509 crossref_primary_10_1177_1060028014555176 crossref_primary_10_1016_j_ijmedinf_2022_104824 crossref_primary_10_1017_S0714980815000057 crossref_primary_10_1111_ijpp_12035 crossref_primary_10_1186_s12877_024_05581_2 crossref_primary_10_1007_s10900_015_0066_5 crossref_primary_10_2196_42274 crossref_primary_10_1016_j_jamda_2021_01_080 crossref_primary_10_1016_j_revmed_2013_02_001 crossref_primary_10_1016_j_pharma_2018_03_009 |
| Cites_doi | 10.1001/archfami.4.12.1017 10.1016/S0002-9343(00)00451-4 10.1001/archinte.161.20.2458 10.1016/j.cger.2005.09.001 10.1023/A:1022018422237 10.1378/chest.127.6.2049 10.1001/archinte.164.1.55 10.1093/geronj/31.2.155 10.1503/cmaj.081229 10.1186/1471-2318-8-13 10.1503/cmaj.080171 10.1001/archinte.167.3.239 10.7326/0003-4819-123-3-199508010-00007 10.1111/j.1532-5415.1998.tb06011.x 10.1378/chest.08-0693 10.1007/s11239-006-9025-4 10.1016/S0009-9236(03)00011-0 10.1001/jama.289.9.1107 10.1097/00063198-200109000-00020 10.1093/geront/41.2.161 10.1001/archinte.1997.00440300080006 10.1111/j.1532-5415.1997.tb05967.x 10.1002/chp.47 10.1016/j.amjmed.2006.07.045 10.1055/s-0038-1651587 |
| ContentType | Journal Article |
| Copyright | Papaioannou et al; licensee BioMed Central Ltd. 2010 COPYRIGHT 2010 BioMed Central Ltd. Copyright ©2010 Papaioannou et al; licensee BioMed Central Ltd. 2010 Papaioannou et al; licensee BioMed Central Ltd. |
| Copyright_xml | – notice: Papaioannou et al; licensee BioMed Central Ltd. 2010 – notice: COPYRIGHT 2010 BioMed Central Ltd. – notice: Copyright ©2010 Papaioannou et al; licensee BioMed Central Ltd. 2010 Papaioannou et al; licensee BioMed Central Ltd. |
| CorporateAuthor | Improving Prescribing in Long Term Care Investigators |
| CorporateAuthor_xml | – name: Improving Prescribing in Long Term Care Investigators |
| DBID | C6C AAYXX CITATION CGR CUY CVF ECM EIF NPM 7X8 5PM DOA |
| DOI | 10.1186/1471-2318-10-38 |
| DatabaseName | Springer Nature OA Free Journals CrossRef Medline MEDLINE MEDLINE (Ovid) MEDLINE MEDLINE PubMed MEDLINE - Academic PubMed Central (Full Participant titles) DOAJ Directory of Open Access Journals |
| DatabaseTitle | CrossRef MEDLINE Medline Complete MEDLINE with Full Text PubMed MEDLINE (Ovid) MEDLINE - Academic |
| DatabaseTitleList | MEDLINE MEDLINE - Academic |
| Database_xml | – sequence: 1 dbid: DOA name: DOAJ Directory of Open Access Journals url: https://www.doaj.org/ sourceTypes: Open Website – sequence: 2 dbid: NPM name: PubMed url: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed sourceTypes: Index Database – sequence: 3 dbid: 7X8 name: MEDLINE - Academic url: https://search.proquest.com/medline sourceTypes: Aggregation Database |
| DeliveryMethod | fulltext_linktorsrc |
| Discipline | Medicine |
| EISSN | 1471-2318 |
| EndPage | 38 |
| ExternalDocumentID | oai_doaj_org_article_dd0c961071424058bcb91c2de445c6ad PMC2902482 A231345919 20537178 10_1186_1471_2318_10_38 |
| Genre | Multicenter Study Comparative Study Research Support, Non-U.S. Gov't Journal Article |
| GeographicLocations | Ontario Canada |
| GeographicLocations_xml | – name: Ontario – name: Canada |
| GrantInformation_xml | – fundername: CIHR grantid: 73426-1 |
| GroupedDBID | --- 0R~ 23N 2VQ 2WC 4.4 53G 5GY 5VS 6J9 6PF 7X7 88E 8FI 8FJ AAFWJ AAJSJ AASML AAWTL ABUWG ACGFO ACGFS ACHQT ACIHN ACPRK ADBBV ADRAZ ADUKV AEAQA AENEX AFKRA AFPKN AHBYD AHMBA AHSBF AHYZX ALMA_UNASSIGNED_HOLDINGS AMKLP AMTXH AOIJS BAPOH BAWUL BCNDV BENPR BFQNJ BMC BPHCQ BVXVI C1A C6C CCPQU CS3 DIK DU5 E3Z EBLON EBS EJD EMB EMOBN F5P FYUFA GROUPED_DOAJ GX1 H13 HMCUK HYE IAO IHR INH INR IPNFZ ITC KQ8 M1P M48 M~E O5R O5S OK1 OVT P2P PGMZT PHGZM PHGZT PIMPY PJZUB PPXIY PQQKQ PROAC PSQYO PUEGO RBZ RIG RNS ROL RPM RSV SMD SOJ SV3 TR2 UKHRP W2D WOQ WOW XSB AAYXX AFFHD CITATION ALIPV CGR CUY CVF ECM EIF NPM PMFND 7X8 5PM |
| ID | FETCH-LOGICAL-c566t-5a1ccb090cd12d61e79ef4ab1e544d0b9c6e445ac603d9f268b715fc27431c213 |
| IEDL.DBID | RSV |
| ISICitedReferencesCount | 16 |
| ISICitedReferencesURI | http://www.webofscience.com/api/gateway?GWVersion=2&SrcApp=Summon&SrcAuth=ProQuest&DestLinkType=CitingArticles&DestApp=WOS_CPL&KeyUT=000208731600038&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| ISSN | 1471-2318 |
| IngestDate | Tue Oct 14 19:08:31 EDT 2025 Tue Nov 04 01:58:18 EST 2025 Sun Nov 09 12:59:57 EST 2025 Tue Nov 11 10:11:55 EST 2025 Tue Nov 04 17:48:28 EST 2025 Sat May 31 02:09:41 EDT 2025 Sat Nov 29 06:37:01 EST 2025 Tue Nov 18 20:31:45 EST 2025 Sat Sep 06 07:30:13 EDT 2025 |
| IsDoiOpenAccess | true |
| IsOpenAccess | true |
| IsPeerReviewed | true |
| IsScholarly | true |
| Issue | 1 |
| Keywords | International Normalize Ratio International Normalize Ratio Testing International Normalize Ratio Range Warfarin International Normalize Ratio Control |
| Language | English |
| License | http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
| LinkModel | DirectLink |
| MergedId | FETCHMERGED-LOGICAL-c566t-5a1ccb090cd12d61e79ef4ab1e544d0b9c6e445ac603d9f268b715fc27431c213 |
| Notes | ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 |
| OpenAccessLink | https://link.springer.com/10.1186/1471-2318-10-38 |
| PMID | 20537178 |
| PQID | 733594404 |
| PQPubID | 23479 |
| PageCount | 1 |
| ParticipantIDs | doaj_primary_oai_doaj_org_article_dd0c961071424058bcb91c2de445c6ad pubmedcentral_primary_oai_pubmedcentral_nih_gov_2902482 proquest_miscellaneous_733594404 gale_infotracmisc_A231345919 gale_infotracacademiconefile_A231345919 pubmed_primary_20537178 crossref_primary_10_1186_1471_2318_10_38 crossref_citationtrail_10_1186_1471_2318_10_38 springer_journals_10_1186_1471_2318_10_38 |
| PublicationCentury | 2000 |
| PublicationDate | 20100610 |
| PublicationDateYYYYMMDD | 2010-06-10 |
| PublicationDate_xml | – month: 6 year: 2010 text: 20100610 day: 10 |
| PublicationDecade | 2010 |
| PublicationPlace | London |
| PublicationPlace_xml | – name: London – name: England |
| PublicationTitle | BMC geriatrics |
| PublicationTitleAbbrev | BMC Geriatr |
| PublicationTitleAlternate | BMC Geriatr |
| PublicationYear | 2010 |
| Publisher | BioMed Central BioMed Central Ltd BMC |
| Publisher_xml | – name: BioMed Central – name: BioMed Central Ltd – name: BMC |
| References | Rogers (CR26) 1983 Jacobs (CR4) 2006; 22 Lackner, Battis (CR16) 1995; 4 Gurwitz, Field, Harrold, Rothschild, Debellis, Seger, Cadoret, Fish, Garber, Kelleher, Bates (CR12) 2003; 289 Rowe, Andres, Tobin, Norris, Shock (CR7) 1976; 31 CR14 Garcia, Regan, Crowther, Hughes, Hylek (CR23) 2005; 127 Mendelson, Aronow (CR15) 1998; 46 Wilson, Costantini, Crowther (CR22) 2007; 23 Monette, Gurwitz, Rochon, Avorn (CR17) 1997; 45 Gurwitz, Field, Avorn, McCormick, Jain, Eckler, Benser, Edmondson, Bates (CR11) 2000; 109 Gurwitz, Field, Radford, Harrold, Becker, Reed, DeBellis, Moldoff, Verzier (CR13) 2007; 120 Harrold, Gurwitz, Tate, Becker, Stuart, Elwell, Radford (CR28) 2002; 14 Henderson, White (CR9) 2001; 7 Oake, Jennings, Forster, Fergusson, Doucette, van Walraven (CR18) 2008; 179 Castle (CR27) 2001; 41 Fang, Stafford, Ruskin, Singer (CR3) 2004; 164 Avorn, Gurwitz (CR6) 1995; 123 Verhovsek, Motlagh, Crowther, Kennedy, Dolovich, Campbell, Wang, Papaioannou (CR19) 2008; 8 Hirsh, Guyatt, Albers, Harrington, Schunemann (CR1) 2008; 133 Gurwitz, Monette, Rochon, Eckler, Avorn (CR10) 1997; 157 Simon, Gurwitz (CR8) 2003; 73 McCormick, Gurwitz, Goldberg, Becker, Tate, Elwell, Radford (CR2) 2001; 161 CR24 White, Gruber, Feyzi, Kaatz, Tse, Husted, Albers (CR5) 2007; 167 Graham, Logan, Harrison, Straus, Tetroe, Caswell, Robinson (CR21) 2006; 26 Straus, Tetroe, Graham (CR20) 2009; 181 Rosendaal, Cannegieter, van der Meer, Briet (CR25) 1993; 69 J Hirsh (327_CR1) 2008; 133 JH Gurwitz (327_CR10) 1997; 157 D McCormick (327_CR2) 2001; 161 G Mendelson (327_CR15) 1998; 46 ID Graham (327_CR21) 2006; 26 SE Wilson (327_CR22) 2007; 23 N Oake (327_CR18) 2008; 179 327_CR24 MC Henderson (327_CR9) 2001; 7 EM Rogers (327_CR26) 1983 MC Fang (327_CR3) 2004; 164 LG Jacobs (327_CR4) 2006; 22 SE Straus (327_CR20) 2009; 181 J Avorn (327_CR6) 1995; 123 JH Gurwitz (327_CR13) 2007; 120 LR Harrold (327_CR28) 2002; 14 J Monette (327_CR17) 1997; 45 SR Simon (327_CR8) 2003; 73 NG Castle (327_CR27) 2001; 41 FR Rosendaal (327_CR25) 1993; 69 HD White (327_CR5) 2007; 167 327_CR14 JH Gurwitz (327_CR11) 2000; 109 JW Rowe (327_CR7) 1976; 31 JH Gurwitz (327_CR12) 2003; 289 TE Lackner (327_CR16) 1995; 4 M Verhovsek (327_CR19) 2008; 8 D Garcia (327_CR23) 2005; 127 |
| References_xml | – year: 1983 ident: CR26 publication-title: Diffusion of Innovation – volume: 4 start-page: 1017 issue: 12 year: 1995 end-page: 1026 ident: CR16 article-title: Use of warfarin for nonvalvular atrial fibrillation in nursing home patients publication-title: Arch Fam Med doi: 10.1001/archfami.4.12.1017 – volume: 109 start-page: 87 issue: 2 year: 2000 end-page: 94 ident: CR11 article-title: Incidence and preventability of adverse drug events in nursing homes publication-title: Am J Med doi: 10.1016/S0002-9343(00)00451-4 – volume: 161 start-page: 2458 issue: 20 year: 2001 end-page: 2463 ident: CR2 article-title: Prevalence and quality of warfarin use for patients with atrial fibrillation in the long-term care setting publication-title: Arch Intern Med doi: 10.1001/archinte.161.20.2458 – volume: 22 start-page: 17 issue: 1 year: 2006 end-page: 32 ident: CR4 article-title: Warfarin pharmacology, clinical management, and evaluation of hemorrhagic risk for the elderly publication-title: Clin Geriatr Med doi: 10.1016/j.cger.2005.09.001 – ident: CR14 – volume: 14 start-page: 59 issue: 1 year: 2002 end-page: 64 ident: CR28 article-title: Physician attitudes concerning anticoagulation services in the long-term care setting publication-title: J Thromb Thrombolysis doi: 10.1023/A:1022018422237 – volume: 127 start-page: 2049 issue: 6 year: 2005 end-page: 2056 ident: CR23 article-title: Warfarin maintenance dosing patterns in clinical practice: implications for safer anticoagulation in the elderly population publication-title: Chest doi: 10.1378/chest.127.6.2049 – volume: 164 start-page: 55 issue: 1 year: 2004 end-page: 60 ident: CR3 article-title: National trends in antiarrhythmic and antithrombotic medication use in atrial fibrillation publication-title: Arch Intern Med doi: 10.1001/archinte.164.1.55 – volume: 31 start-page: 155 issue: 2 year: 1976 end-page: 163 ident: CR7 article-title: The effect of age on creatinine clearance in men: a cross-sectional and longitudinal study publication-title: J Gerontol doi: 10.1093/geronj/31.2.155 – volume: 181 start-page: 165 issue: 3-4 year: 2009 end-page: 168 ident: CR20 article-title: Defining knowledge translation publication-title: CMAJ doi: 10.1503/cmaj.081229 – volume: 8 start-page: 13 year: 2008 ident: CR19 article-title: Quality of anticoagulation and use of warfarin-interacting medications in long-term care: a chart review publication-title: BMC Geriatr doi: 10.1186/1471-2318-8-13 – volume: 179 start-page: 235 issue: 3 year: 2008 end-page: 244 ident: CR18 article-title: Anticoagulation intensity and outcomes among patients prescribed oral anticoagulant therapy: a systematic review and meta-analysis publication-title: CMAJ doi: 10.1503/cmaj.080171 – volume: 167 start-page: 239 issue: 3 year: 2007 end-page: 245 ident: CR5 article-title: Comparison of outcomes among patients randomized to warfarin therapy according to anticoagulant control: results from SPORTIF III and V publication-title: Arch Intern Med doi: 10.1001/archinte.167.3.239 – volume: 123 start-page: 195 issue: 3 year: 1995 end-page: 204 ident: CR6 article-title: Drug use in the nursing home publication-title: Ann Intern Med doi: 10.7326/0003-4819-123-3-199508010-00007 – volume: 46 start-page: 1423 issue: 11 year: 1998 end-page: 1424 ident: CR15 article-title: Underutilization of warfarin in older persons with chronic nonvalvular atrial fibrillation at high risk for developing stroke publication-title: J Am Geriatr Soc doi: 10.1111/j.1532-5415.1998.tb06011.x – volume: 133 start-page: 71S issue: suppl 6 year: 2008 end-page: 109S ident: CR1 article-title: Executive summary: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines publication-title: Chest doi: 10.1378/chest.08-0693 – volume: 23 start-page: 195 issue: 3 year: 2007 end-page: 198 ident: CR22 article-title: Paper-based dosing algorithms for maintenance of warfarin anticoagulation publication-title: J Thromb Thrombolysis doi: 10.1007/s11239-006-9025-4 – volume: 73 start-page: 387 issue: 5 year: 2003 end-page: 393 ident: CR8 article-title: Drug therapy in the elderly: improving quality and access publication-title: Clin Pharmacol Ther doi: 10.1016/S0009-9236(03)00011-0 – volume: 69 start-page: 236 issue: 3 year: 1993 end-page: 239 ident: CR25 article-title: A method to determine the optimal intensity of oral anticoagulant therapy publication-title: Thromb Haemost – volume: 289 start-page: 1107 issue: 9 year: 2003 end-page: 1116 ident: CR12 article-title: Incidence and preventability of adverse drug events among older persons in the ambulatory setting publication-title: JAMA doi: 10.1001/jama.289.9.1107 – volume: 7 start-page: 365 issue: 5 year: 2001 end-page: 370 ident: CR9 article-title: Anticoagulation in the elderly publication-title: Curr Opin Pulm Med doi: 10.1097/00063198-200109000-00020 – volume: 41 start-page: 161 issue: 2 year: 2001 end-page: 172 ident: CR27 article-title: Innovation in nursing homes: which facilities are the early adopters? publication-title: Gerontologist doi: 10.1093/geront/41.2.161 – volume: 157 start-page: 978 issue: 9 year: 1997 end-page: 984 ident: CR10 article-title: Atrial fibrillation and stroke prevention with warfarin in the long-term care setting publication-title: Arch Intern Med doi: 10.1001/archinte.1997.00440300080006 – volume: 45 start-page: 1060 issue: 9 year: 1997 end-page: 1065 ident: CR17 article-title: Physician attitudes concerning warfarin for stroke prevention in atrial fibrillation: results of a survey of long-term care practitioners publication-title: J Am Geriatr Soc doi: 10.1111/j.1532-5415.1997.tb05967.x – volume: 26 start-page: 13 issue: 1 year: 2006 end-page: 24 ident: CR21 article-title: Lost in knowledge translation: time for a map? publication-title: J Contin Educ Health Prof doi: 10.1002/chp.47 – volume: 120 start-page: 539 issue: 6 year: 2007 end-page: 544 ident: CR13 article-title: The safety of warfarin therapy in the nursing home setting publication-title: Am J Med doi: 10.1016/j.amjmed.2006.07.045 – ident: CR24 – volume: 289 start-page: 1107 issue: 9 year: 2003 ident: 327_CR12 publication-title: JAMA doi: 10.1001/jama.289.9.1107 – volume: 22 start-page: 17 issue: 1 year: 2006 ident: 327_CR4 publication-title: Clin Geriatr Med doi: 10.1016/j.cger.2005.09.001 – volume: 161 start-page: 2458 issue: 20 year: 2001 ident: 327_CR2 publication-title: Arch Intern Med doi: 10.1001/archinte.161.20.2458 – volume: 123 start-page: 195 issue: 3 year: 1995 ident: 327_CR6 publication-title: Ann Intern Med doi: 10.7326/0003-4819-123-3-199508010-00007 – volume: 41 start-page: 161 issue: 2 year: 2001 ident: 327_CR27 publication-title: Gerontologist doi: 10.1093/geront/41.2.161 – volume: 109 start-page: 87 issue: 2 year: 2000 ident: 327_CR11 publication-title: Am J Med doi: 10.1016/S0002-9343(00)00451-4 – volume: 120 start-page: 539 issue: 6 year: 2007 ident: 327_CR13 publication-title: Am J Med doi: 10.1016/j.amjmed.2006.07.045 – volume: 45 start-page: 1060 issue: 9 year: 1997 ident: 327_CR17 publication-title: J Am Geriatr Soc doi: 10.1111/j.1532-5415.1997.tb05967.x – volume: 31 start-page: 155 issue: 2 year: 1976 ident: 327_CR7 publication-title: J Gerontol doi: 10.1093/geronj/31.2.155 – volume: 8 start-page: 13 year: 2008 ident: 327_CR19 publication-title: BMC Geriatr doi: 10.1186/1471-2318-8-13 – volume: 14 start-page: 59 issue: 1 year: 2002 ident: 327_CR28 publication-title: J Thromb Thrombolysis doi: 10.1023/A:1022018422237 – volume: 73 start-page: 387 issue: 5 year: 2003 ident: 327_CR8 publication-title: Clin Pharmacol Ther doi: 10.1016/S0009-9236(03)00011-0 – volume: 179 start-page: 235 issue: 3 year: 2008 ident: 327_CR18 publication-title: CMAJ doi: 10.1503/cmaj.080171 – volume: 133 start-page: 71S issue: suppl 6 year: 2008 ident: 327_CR1 publication-title: Chest doi: 10.1378/chest.08-0693 – volume: 26 start-page: 13 issue: 1 year: 2006 ident: 327_CR21 publication-title: J Contin Educ Health Prof doi: 10.1002/chp.47 – volume: 157 start-page: 978 issue: 9 year: 1997 ident: 327_CR10 publication-title: Arch Intern Med doi: 10.1001/archinte.1997.00440300080006 – ident: 327_CR24 – volume: 46 start-page: 1423 issue: 11 year: 1998 ident: 327_CR15 publication-title: J Am Geriatr Soc doi: 10.1111/j.1532-5415.1998.tb06011.x – volume: 4 start-page: 1017 issue: 12 year: 1995 ident: 327_CR16 publication-title: Arch Fam Med doi: 10.1001/archfami.4.12.1017 – volume: 164 start-page: 55 issue: 1 year: 2004 ident: 327_CR3 publication-title: Arch Intern Med doi: 10.1001/archinte.164.1.55 – volume: 7 start-page: 365 issue: 5 year: 2001 ident: 327_CR9 publication-title: Curr Opin Pulm Med doi: 10.1097/00063198-200109000-00020 – volume: 69 start-page: 236 issue: 3 year: 1993 ident: 327_CR25 publication-title: Thromb Haemost doi: 10.1055/s-0038-1651587 – volume: 167 start-page: 239 issue: 3 year: 2007 ident: 327_CR5 publication-title: Arch Intern Med doi: 10.1001/archinte.167.3.239 – volume: 127 start-page: 2049 issue: 6 year: 2005 ident: 327_CR23 publication-title: Chest doi: 10.1378/chest.127.6.2049 – volume-title: Diffusion of Innovation year: 1983 ident: 327_CR26 – volume: 181 start-page: 165 issue: 3-4 year: 2009 ident: 327_CR20 publication-title: CMAJ doi: 10.1503/cmaj.081229 – ident: 327_CR14 – volume: 23 start-page: 195 issue: 3 year: 2007 ident: 327_CR22 publication-title: J Thromb Thrombolysis doi: 10.1007/s11239-006-9025-4 |
| SSID | ssj0017826 |
| Score | 1.9545071 |
| Snippet | Background
Previous studies in long-term care (LTC) have demonstrated that warfarin management is suboptimal with preventable adverse events often occurring as... Previous studies in long-term care (LTC) have demonstrated that warfarin management is suboptimal with preventable adverse events often occurring as a result... Background Previous studies in long-term care (LTC) have demonstrated that warfarin management is suboptimal with preventable adverse events often occurring as... Abstract Background Previous studies in long-term care (LTC) have demonstrated that warfarin management is suboptimal with preventable adverse events often... |
| SourceID | doaj pubmedcentral proquest gale pubmed crossref springer |
| SourceType | Open Website Open Access Repository Aggregation Database Index Database Enrichment Source Publisher |
| StartPage | 38 |
| SubjectTerms | Aged Aged patients Aged, 80 and over Aging Analysis Cohort Studies Disease Management Drug therapy Electronic Health Records - standards Feasibility Studies Female Geriatrics/Gerontology Health aspects Homes for the Aged - standards Hospital information systems Hospitals Humans Information storage and retrieval systems International Normalized Ratio - methods International Normalized Ratio - standards Long-Term Care - methods Long-Term Care - standards Male Medicine Medicine & Public Health Nursing Homes - standards Ontario - epidemiology Patient Care Team - standards Pilot Projects Prevention Rehabilitation Research Article Retrospective Studies Thromboembolism Warfarin Warfarin - blood Warfarin - therapeutic use |
| SummonAdditionalLinks | – databaseName: DOAJ Directory of Open Access Journals dbid: DOA link: http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwrV3LbtUwELVQhRAbxJtAQbNAAhah8SOxze4CrWDRK4RA6s5ybIdWapPqPkB8AP-NJ3FCU1SxYRnbUeKZ45mxPD5DyPO4M45em8lcy4bnglqZ28BDXkVvVnvGrZdDsQm5XKqjI_3pQqkvzAkb6IEHwe15XzgdfbzEK1lFqWpXa-qYD0KUrrIerW8h9biZSucH0e8N94okzWMEoxKpD1XV3tTWWyA180c9bf_fxvmCd7qcOXnp-LT3Sge3ya0UTsJimMYdci20d8mNw3Rgfo_8WkDU4lmOzsrDSCAOmw5-2FUT98ktnE0JMBCfTrv2G6C5BswJewMLaIJNKbQ_oSejha6BGDbC4f778HH5Gf5U0gGfKvbAenuOgT0MRNH3ydeD_S_vPuSp8kLuYni3yUtLnasLXThPma9okDo0wtY0lEL4otauQvlbVxXc64ZVqpa0bBzDeMQxyh-QnbZrwyO8E-5LHtXBXXCCi6BKFpC1TgYhuWI6I69H-RuXaMmxOsap6bcnqjKoMIMKwxauMvJyeuF8YOS4euhbVOg0DKm0-4YIMJMAZv4FsIy8QDgYXPDxx5xN9xbi9JA6yyzi97goNY1T2Z2NjAvVzbphBJTBLsxua0O3XRvJeamRqDEjDwd8Tb_MkG8nwjkjcoa82ZzmPe3JcU8TzjTy1bGMvBoxapJ9Wl8lsMf_Q2BPyM0hxaKKK2yX7GxW2_CUXHffNyfr1bN-nf4GC7o8xg priority: 102 providerName: Directory of Open Access Journals |
| Title | A team-based approach to warfarin management in long term care: A feasibility study of the MEDeINR electronic decision support system |
| URI | https://link.springer.com/article/10.1186/1471-2318-10-38 https://www.ncbi.nlm.nih.gov/pubmed/20537178 https://www.proquest.com/docview/733594404 https://pubmed.ncbi.nlm.nih.gov/PMC2902482 https://doaj.org/article/dd0c961071424058bcb91c2de445c6ad |
| Volume | 10 |
| WOSCitedRecordID | wos000208731600038&url=https%3A%2F%2Fcvtisr.summon.serialssolutions.com%2F%23%21%2Fsearch%3Fho%3Df%26include.ft.matches%3Dt%26l%3Dnull%26q%3D |
| hasFullText | 1 |
| inHoldings | 1 |
| isFullTextHit | |
| isPrint | |
| journalDatabaseRights | – providerCode: PRVADU databaseName: BioMedCentral customDbUrl: eissn: 1471-2318 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0017826 issn: 1471-2318 databaseCode: RBZ dateStart: 20010101 isFulltext: true titleUrlDefault: https://www.biomedcentral.com/search/ providerName: BioMedCentral – providerCode: PRVAON databaseName: DOAJ Directory of Open Access Journals customDbUrl: eissn: 1471-2318 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0017826 issn: 1471-2318 databaseCode: DOA dateStart: 20010101 isFulltext: true titleUrlDefault: https://www.doaj.org/ providerName: Directory of Open Access Journals – providerCode: PRVHPJ databaseName: ROAD: Directory of Open Access Scholarly Resources customDbUrl: eissn: 1471-2318 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0017826 issn: 1471-2318 databaseCode: M~E dateStart: 20010101 isFulltext: true titleUrlDefault: https://road.issn.org providerName: ISSN International Centre – providerCode: PRVPQU databaseName: Health & Medical Collection customDbUrl: eissn: 1471-2318 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0017826 issn: 1471-2318 databaseCode: 7X7 dateStart: 20090101 isFulltext: true titleUrlDefault: https://search.proquest.com/healthcomplete providerName: ProQuest – providerCode: PRVPQU databaseName: ProQuest Central customDbUrl: eissn: 1471-2318 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0017826 issn: 1471-2318 databaseCode: BENPR dateStart: 20090101 isFulltext: true titleUrlDefault: https://www.proquest.com/central providerName: ProQuest – providerCode: PRVPQU databaseName: Publicly Available Content Database (ProQuest) customDbUrl: eissn: 1471-2318 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0017826 issn: 1471-2318 databaseCode: PIMPY dateStart: 20090101 isFulltext: true titleUrlDefault: http://search.proquest.com/publiccontent providerName: ProQuest – providerCode: PRVAVX databaseName: SpringerLINK Contemporary 1997-Present customDbUrl: eissn: 1471-2318 dateEnd: 99991231 omitProxy: false ssIdentifier: ssj0017826 issn: 1471-2318 databaseCode: RSV dateStart: 20011201 isFulltext: true titleUrlDefault: https://link.springer.com/search?facet-content-type=%22Journal%22 providerName: Springer Nature |
| link | http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1Lb9QwELb6QIhLedNAWfmABBxCEzuJbW5b2IoedrVaHlpOVmI7pVKbVPsA8QP438w4yUIKPcAlUmJH8difZ8bx-BtCnsHKGKw2E6ESJQ-TOBdh7rgLM7BmhWU8t6JJNiEmEzmfq-kWibuzMD7avduS9JraT2uZHcagRkPwRjwbKZfbZBdsncRsDbP3nzYbB2DwspbB5y8v9YyP5-j_UxP_Zoquhkle2Sv1Juj49n80_g7Za_1NOmwAcpdsueoeuTlud9Tvkx9DCsN8EaI1s7RjGKermn7LFyUspCt6sYmQoXB3XlenFPU5xaCx13RIS5e3MbbfqWerpXVJwa-k49FbdzKZ0V-pdqhtU_rQ5foSPX_aMEk_IB-PRx_evAvb1AyhAf9vFaZ5bEwRqcjYmNksdkK5MsmL2KVJYqNCmcwlSZqbLOJWlSyThYjT0jB0WAyL-UOyU9WV28dD4zblMGzcOJPwxMmUOaS1Ey4RXDIVkFfdmGnT8pZj-oxz7dcvMtPYuRo7F59wGZAXmxcuG8qO66seIQg21ZBr2z-oF6e6nbra2sgo8DIFHgqMUlmYQoEMFgU0WW4D8hwhpFEjQMNM3h5sAPGQW0sP4Xs8SVUMohz0asJMNr1i2oFQYxGGv1WuXi-14DxVyOQYkEcNJjdNZkjIA7APiOihtSdTv6Q6--J5xJlCQjsWkJcdZnWrwJbXddjjf6j7hNxqQi0yAP0B2Vkt1u4puWG-rs6WiwHZFnPhr3JAdo9Gk-ls4H-IwN30ZDz9PPAT-yeQY0KV |
| linkProvider | Springer Nature |
| linkToHtml | http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1Jb9UwELZKQcCFfQkU8AEJOATiJXHM7QGtWtH3hEpBvVmJ7ZRKbVK9BcQP4H8z4yyQQg9wjBfFY89mzfgbQp7CzRisNlexVpWIJStUXHjh4wysWem4KJxqi02o2Sw_ONAf1gjr38KEbPc-JBk0dRDrPHvFQI3G4I0ENFKRXyAXJZgrhMvf-_h5CByAwcs6BJ-_TBoZn4DR_6cm_s0UnU2TPBMrDSZo6_p_LP4Gudb5m3TSMshNsubrW-TytIuo3yY_JhSO-SRGa-ZojzBOlw39VswruEjX9GTIkKHwddzUhxT1OcWksdd0QitfdDm232lAq6VNRcGvpNPNd35ntkd_ldqhrivpQxerU_T8aYskfYd82trcf7sdd6UZYgv-3zJOC2ZtmejEOsZdxrzSvpJFyXwqpUtKbTMvZVrYLBFOVzzLS8XSynJ0WCxn4i5Zr5va38dH4y4VcGzCeiuF9HnKPcLaKS-VyLmOyMv-zIztcMuxfMaxCfeXPDO4uQY3F1tEHpHnw4TTFrLj_KFvkAmGYYi1HRqa-aHpRNc4l1gNXqbCR4FJmpe21ECDQwJtVriIPEMWMqgRYGG26B42AHmIrWUm8D8hU82AlI3RSJBkO-qmPRMa7ML0t9o3q4VRQqQakRwjcq_lyWHJHAF5gO0jokbcOqJp3FMffQk44lwjoB2PyIueZ02nwBbnbdiDfxj7hFzZ3p_umt2d2fuH5GqbdpGBAGyQ9eV85R-RS_br8mgxfxxE-CcCfz9p |
| linkToPdf | http://cvtisr.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwpV1Lb9QwELagoIoL70eggA9IwCE0sZ045rbQrqigq4qXerMS2ymV2mS1yYL4AfxvZhInkEIPiOPGjjZjz1P-_A0hT6AyhqjNZKhkyUMR5zLMHXdhCtGssIznVvbNJuRikR0eqgOPzWkGtPtwJNnfaUCWpqrdXtqyN_Es3Y7BpYaQmXTMpDy7SC4JRNFjsf7h83iIAMEv9Ww-f3lpEog6vv4_vfJvYeksZPLMuWkXjubX_lOQ6-Sqz0PprFecG-SCq26SzX1_0n6L_JhR2P7TEKOcpQPzOG1r-i1flVBgV_R0RM5Q-HVSV0cU_TxFMNlLOqOlyz329jvtWGxpXVLIN-n-7o7bW7ynv1rwUOtb_dBmvcSKgPYM07fJp_nux9dvQt-yITSQF7ZhksfGFJGKjI2ZTWMnlStFXsQuEcJGhTKpEyLJTRpxq0qWZoWMk9IwTGQMi_kdslHVlbuHl8ltwmELuXFGcOGyhDmku5NOSJ4xFZAXw_5p4_nMsa3Gie7qmizVuLgaFxef8Cwgz8YXlj2Vx_lTX6FCjNOQg7t7UK-OtDdpbW1kFGSfEi8LRklWmEKBDBYFNGluA_IU1Umjp4APM7m_8ADiIeeWnsH_cZGoGETZmswECzeTYToopMYhhMVVrl43WnKeKGR4DMjdXj_HT2ZI1AMmEBA50dyJTNOR6vhLxy_OFBLdsYA8H_RXe8fWnLdg9_9h7mOyebAz1-_2Fm8fkCs9GiMF_d8iG-1q7R6Sy-Zre9ysHnXW_BMkF0hN |
| openUrl | ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=A+team-based+approach+to+warfarin+management+in+long+term+care%3A+A+feasibility+study+of+the+MEDeINR+electronic+decision+support+system&rft.jtitle=BMC+geriatrics&rft.au=Papaioannou%2C+Alexandra&rft.au=Kennedy%2C+Courtney+C&rft.au=Campbell%2C+Glenda&rft.au=Stroud%2C+Jacqueline+B&rft.date=2010-06-10&rft.pub=BioMed+Central+Ltd&rft.issn=1471-2318&rft.eissn=1471-2318&rft.volume=10&rft.spage=38&rft_id=info:doi/10.1186%2F1471-2318-10-38&rft.externalDocID=A231345919 |
| thumbnail_l | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=1471-2318&client=summon |
| thumbnail_m | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=1471-2318&client=summon |
| thumbnail_s | http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=1471-2318&client=summon |