Monitoring Unfractionated Heparin Therapy with Antifactor Xa Activity Results in Fewer Monitoring Tests and Dosage Changes than Monitoring with the Activated Partial Thromboplastin Time

Study Objective. To determine how much more costly it is to monitor unfractionated heparin (UFH) therapy by antifactor Xa heparin activity (HA) than by activated partial thromboplastin time (aPTT). Design. Prospective, randomized, unmasked, cohort, single‐center study. Setting. A 625‐bed, adults‐onl...

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Bibliographic Details
Published in:Pharmacotherapy 1999-06, Vol.19 (6), p.760-766
Main Author: Rosborough, Terry K.
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Analysis of Variance
Anticoagulants - administration & dosage
Anticoagulants - blood
Biological and medical sciences
Blood. Blood coagulation. Reticuloendothelial system
Cohort Studies
Drug Monitoring - economics
Drug Monitoring - standards
Factor Xa Inhibitors
Female
Heparin - administration & dosage
Heparin - blood
Humans
Male
Medical sciences
Middle Aged
Partial Thromboplastin Time
Pharmacology. Drug treatments
Prospective Studies
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Summary:Study Objective. To determine how much more costly it is to monitor unfractionated heparin (UFH) therapy by antifactor Xa heparin activity (HA) than by activated partial thromboplastin time (aPTT). Design. Prospective, randomized, unmasked, cohort, single‐center study. Setting. A 625‐bed, adults‐only, private teaching hospital. Patients. Two hundred sixty‐eight patients with a variety of indications for UFH therapy. Interventions. Patients were treated with UFH based on ideal weight (75 U/kg bolus, 20 U/kg initial infusion) and monitored by either HA or aPTT. Measurements and Main Results. After adjusting for gender, groups were equivalent in patient characteristics and UFH dosage. The HA group had fewer monitoring tests and dosage changes/24 hours than the aPTT group. These reductions neutralized much of the increased cost of the HA assay itself. Conclusion. Monitoring UFH therapy over 96 hours with an HA assay costs $4.37 more than monitoring with aPTT. This modest increase may be acceptable given other advantages of the HA assay.
ISSN:0277-0008
1875-9114
DOI:10.1592/phco.19.9.760.31547