PERCEPTIONS ABOUT 'RAPID' WARFARIN REVERSAL WITH FRESH FROZEN PLASMA TO REDUCE THE INR- A NOVEL SURVEY METHODOLOGY

Author(s)

Petrozzino J1, Hoesche J2, Jones C21Compara Biomedical, Orlando, FL, USA, 2CSL Behring, King of Prussia, PA, USA

OBJECTIVES: To determine health care provider perceptions about timing of 'rapid' warfarin reversal-related patient care events using novel survey methodology. METHODS: Forty-eight adult and pediatric trauma centers were contacted to participate in a direct-to-provider (DTP) survey. Participants were asked to provide aggregate information about patients receiving fresh-frozen plasma (FFP) for acute warfarin reversal. RESULTS: Nineteen to 25 health care professionals from 18 centers provided information by survey. Average perceptions of time needed to infuse FFP under this setting (mean 4.6 hrs from time of triage; 95% CI 1.0 – 8.2 hrs) are consistent with actual, published values. In contrast, average perceptions of time needed for initial International Normalized Ratio (INR) normalization using FFP (mean 5.8 hrs; 95% CI 2.8 – 8.8 hrs) underestimate actual, published values by 6 – 26 hrs. Health care providers perceived that relatively little cumulative time lapses (1.6 hrs, on the average) for completing the first FFP infusion. There is little perceived time lag between ordering and beginning the first FFP infusion (0.3 hrs, on the average), consistent with actual, published values. There is substantial reported time (an additional 3.0 hrs, on the average) needed to complete subsequent FFP infusions, amounting to 52% of all perceived time lapsing for initial INR normalization in this setting. CONCLUSIONS: DTP survey methodology appears to be an efficient method for gathering clinical information for research purposes. Healthcare providers may have perceptions that are different from published studies, including inaccurate perceptions of the delay between the time FFP infusions are completed and time of initial INR normalization. To our knowledge, this is the first study to show that subsequent-to-first FFP dose infusion times account for the majority of perceived INR normalization time. Delays to treatment completion may present serious downstream consequences. Such perceptions may influence clinical decision making, and warrant further analysis and investigation.

Conference/Value in Health Info

2011-05, ISPOR 2011, Baltimore, MD, USA

Value in Health, Vol. 14, No. 3 (May 2011)

Code

PSY81

Topic

Methodological & Statistical Research

Topic Subcategory

Modeling and simulation

Disease

Systemic Disorders/Conditions

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