[Current status of oral anticoagulation control in primary care]

Abstract

Objective: To know the present situation about the follow-up of the patients with oral anticoagulant therapy (OAT) in primary care centers, the difficulties felt in its implantation and the professionals attitudes.

Design: Cross-sectional descriptive study.

Setting: All Spanish primary care centers.

Participants: The study subjects are the managers of all primary care centers. We selected a sample of 227 centers (the total number is 1854), for prevalence of 50%, confidence at 95%, precision 7% and 30% loss. The sample is stratified by regions.

Measurements and main results: We sent a questionnaire by post to the managers of sample primary care centers. We sent a new mailing, after three months, to the "no answers". A rate of 72.7% answers were obtained. 23% of sample primary care centers do follow-up of OAT al less in a part of the patients. Reduced access to hospital is the only structural cause that it has influence significantly. The main problem to carry out this activity is coordination with Haematology reference service.

Conclusions: One every four Spanish primary care centers make the follow-up of OAT, higher when primary care centers are far away from hospital. So, accessibility is the factor with more influence in the decision of carry out OAT follow-up. Coordination with haematology services is the main problem to solve.