How to Stop the Bleeding

November 18th, 2008 | Sources: Washington Post

Giving patients written instructions on the proper use of blood thinning medication reduces the risk of life threatening complications such as gastrointestinal bleeding and hemorrhagic stroke, according to the results of a study published in the Journal of General Internal Medicine.

Dr. Joshua P. Metlay and his team at the University of Pennsylvania reached this conclusion after studying 2,346 elderly patients that took Coumadin for various reasons.

The scientists found that only 55% of patients in the study recalled getting medication instructions of any type from nurses or physicians.

Patients that did recall receiving instructions from a nurse or a doctor plus a pharmacist were 60% less likely to incur a serious bleeding complication in the ensuing 2 years. This benefit was independent of cognitive function, patient age, living arrangements and the number of co-administered medications.

Only written instructions seemed to make a difference. Verbal instructions did not reduce the risk of bleeding complications.

“While we do not know the specific mechanism linking the medication instructions to reduced bleeding risk, it is likely that improved communication about medications leads to increased drug adherence and earlier recognition of medication side effects,” Dr. Metlay said in a press release picked up by the Washington Post.

The results of the study support the FDA’s 2006 mandate that a medication guide be distributed to patients taking Coumadin. The study design used here did not allow scientists to determine the optimal format for written instructions or to evaluate the instructions put forward by Bristol-Meyers, the makers of Coumadin, in response to the FDA mandate.


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