Bleeding associated with self-medication in warfarin users: A prospective observational study in Ijuí (Brazil)
Abstract Warfarin has been associated with bleeding and venous thromboembolism. Objective: This study aimed to estimate the association between bleeding and concomitant self-medication, and the incidence of adverse drug reactions in patients using warfarin. Setting: the public health network of Ijuí...
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| Format: | Article |
| Language: | English |
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Universidade de São Paulo
2023-01-01
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| Series: | Brazilian Journal of Pharmaceutical Sciences |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1984-82502022000100892&tlng=en |
| _version_ | 1797951310443577344 |
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| author | Christiane Colet Tânia Alves Amador Stela Castro Albert Figueras Isabela Heineck |
| author_facet | Christiane Colet Tânia Alves Amador Stela Castro Albert Figueras Isabela Heineck |
| author_sort | Christiane Colet |
| collection | DOAJ |
| description | Abstract Warfarin has been associated with bleeding and venous thromboembolism. Objective: This study aimed to estimate the association between bleeding and concomitant self-medication, and the incidence of adverse drug reactions in patients using warfarin. Setting: the public health network of Ijuí, a municipality in southern Brazil. This was an open prospective cohort, conducted for a period of 18 months with users of warfarin, treated at the public health service. The association between bleeding and self-medication was evaluated by means of the Cox Model with left truncation, using the time variable. Main outcome measurement: bleeding reported in the follow-up. Cases of thromboembolism and death were also registered. All patients treated with warfarin in the public health system of the municipality (98) were identified. Sixty-eight were interviewed and followed up, of whom 63 completed follow-up and five died during the study. Bleeding rates of 37.7 /100 patients/year, thromboembolism of 4.8/100 patients / year and deaths of 4.8 /100 patients / year were observed. The results showed that patients, who take warfarin and self-medicated present a two-fold increased bleeding, compared with those who do not self-medicate. The bleeding risk associated with self-medication ranged from 2.001 to 2.685; those values maintained their significance even when adjusted for number of interactions, CYP polymorphism, TTR and age in COX analysis. These results greatly suggest the need for providing greater assistance to patients who take anticoagulant medications with the purpose of reducing self-medication and consequently, adverse reactions. |
| first_indexed | 2024-04-10T22:28:32Z |
| format | Article |
| id | doaj.art-5f570d20daa84437b2656df731ebdfb9 |
| institution | Directory Open Access Journal |
| issn | 2175-9790 |
| language | English |
| last_indexed | 2024-04-10T22:28:32Z |
| publishDate | 2023-01-01 |
| publisher | Universidade de São Paulo |
| record_format | Article |
| series | Brazilian Journal of Pharmaceutical Sciences |
| spelling | doaj.art-5f570d20daa84437b2656df731ebdfb92023-01-17T07:34:25ZengUniversidade de São PauloBrazilian Journal of Pharmaceutical Sciences2175-97902023-01-015810.1590/s2175-97902022e20959Bleeding associated with self-medication in warfarin users: A prospective observational study in Ijuí (Brazil)Christiane ColetTânia Alves AmadorStela Castrohttps://orcid.org/0000-0001-5862-6709Albert FiguerasIsabela Heineckhttps://orcid.org/0000-0002-8448-5994Abstract Warfarin has been associated with bleeding and venous thromboembolism. Objective: This study aimed to estimate the association between bleeding and concomitant self-medication, and the incidence of adverse drug reactions in patients using warfarin. Setting: the public health network of Ijuí, a municipality in southern Brazil. This was an open prospective cohort, conducted for a period of 18 months with users of warfarin, treated at the public health service. The association between bleeding and self-medication was evaluated by means of the Cox Model with left truncation, using the time variable. Main outcome measurement: bleeding reported in the follow-up. Cases of thromboembolism and death were also registered. All patients treated with warfarin in the public health system of the municipality (98) were identified. Sixty-eight were interviewed and followed up, of whom 63 completed follow-up and five died during the study. Bleeding rates of 37.7 /100 patients/year, thromboembolism of 4.8/100 patients / year and deaths of 4.8 /100 patients / year were observed. The results showed that patients, who take warfarin and self-medicated present a two-fold increased bleeding, compared with those who do not self-medicate. The bleeding risk associated with self-medication ranged from 2.001 to 2.685; those values maintained their significance even when adjusted for number of interactions, CYP polymorphism, TTR and age in COX analysis. These results greatly suggest the need for providing greater assistance to patients who take anticoagulant medications with the purpose of reducing self-medication and consequently, adverse reactions.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1984-82502022000100892&tlng=enBleedingself-medicationWarfarinAdverse effectsprimary careBrazil |
| spellingShingle | Christiane Colet Tânia Alves Amador Stela Castro Albert Figueras Isabela Heineck Bleeding associated with self-medication in warfarin users: A prospective observational study in Ijuí (Brazil) Brazilian Journal of Pharmaceutical Sciences Bleeding self-medication Warfarin Adverse effects primary care Brazil |
| title | Bleeding associated with self-medication in warfarin users: A prospective observational study in Ijuí (Brazil) |
| title_full | Bleeding associated with self-medication in warfarin users: A prospective observational study in Ijuí (Brazil) |
| title_fullStr | Bleeding associated with self-medication in warfarin users: A prospective observational study in Ijuí (Brazil) |
| title_full_unstemmed | Bleeding associated with self-medication in warfarin users: A prospective observational study in Ijuí (Brazil) |
| title_short | Bleeding associated with self-medication in warfarin users: A prospective observational study in Ijuí (Brazil) |
| title_sort | bleeding associated with self medication in warfarin users a prospective observational study in ijui brazil |
| topic | Bleeding self-medication Warfarin Adverse effects primary care Brazil |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1984-82502022000100892&tlng=en |
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