Warfarin Care enrolment and procedure
Sullivan Nicolaides Pathology's Warfarin Care program is a service provided to patients of SNP's regular referring doctors.
For patient safety reasons, we will not accept patients into our Warfarin Care program where we do not have regular communications with the patient's general practitioner.
This precludes patients of general practitioners who do not usually refer to SNP and patients directly from public hospitals. SNP reserves the right to refuse enrolment of any patient for patient safety reasons.
Doctors' responsibilities when referring to Sullivan Nicolaides Pathology Warfarin Care
The Royal College of Pathologists of Australasia has been asked to recommend to their members that they proactively seek for the general practitioners of their long term anticoagulation therapy patients, an annual update of information that is clinically relevant to optimal anticoagulation therapy management,including indications for anticoagulant therapy, adverse clotting events, planned surgery, prescribed medications and other changes to the patient's circumstances.
Before enrolment, please assess your patient's eligilibility for our Warfarin Care program according to our enrolment & eligibility criteria below.
For more information, please contact Warfarin Care on Ph (07) 3377 8578 or Fax (07) 3377 8461.
Office hours are Monday - Friday 10.00am to 4.00pm, closed weekends and public holidays.
To be eligible for enrolment on our program, your patient must:
- Be taking warfarin (not dindevan medication)
- Have a minimum enrolment period of one month
- Have a general practitioner who refers their patients to Sullivan Nicolaides Pathology
- Have a valid contact phone number and mailing address
- Be able to comprehend and record verbal dose instructions
- Be able to comply with dose instructions (or has a carer who can comply)
- Be able to attend for testing on scheduled dates, subject to exceptional circumstances
- Not have been discharged from a warfarin care program due to non-compliance
- Not require a narrow target range (less than one unit)
- Not require daily INR levels
- Not require acute care
Ongoing patient eligibility criteria
Patients who were eligible on enrolment will become ineligible for our Warfarin Care program if they:
- Require a narrow target range
- Require daily INR levels
- Are non-compliant
- Become unable to follow verbal or written dose instructions
- Are abusive to Sullivan Nicolaides Pathology staff
- Develop complex clinical conditions or become unstable where one-on-one management by their own referring doctor is necessary
- Experience ongoing difficulties attending on scheduled test dates - for example, patients who reside in remote areas or whose employment requires frequent travel
You will be advised of our concerns regarding your patient's suitability for our program. If these concerns are not resolved, then we will return the responsibility for managing your patient's warfarin therapy to you.
Before enrolment, please:
- Assess your patient's eligibility for our Warfarin Care program according to our above eligibility criteria.
- Provide your patient with adequate dosing instructions until Warfarin Care support have notified you and your patient that the enrolment process is complete. Allow at least 3 working days.
The doctor, nurse, or practice manager must fax the completed enrolment application to SNP Warfarin Care Support to enrol your patient. Please retain this original enrolment application for future reference.
Your patient's eligibility will be assessed and we will notify you if our program is not suitable for your patient.
The referring doctor must manage the patient's heparin therapy, including low molecular weight heparin such as Clexane. Heparin therapy (UF or LMWH) should continue until INR is in the therapeutic range for at least 48 hours.
We cannot commence enrolments on Fridays, weekends, or public holidays. Enrolment days will be limited prior to Easter, Christmas and New Year to allow the safe transfer of your patient onto our program.
Enrolment in our Warfarin Care program is contingent upon all parties - doctor, patient, and laboratory - understanding and accepting their roles and responsibilities as outlined in the Sullivan Nicolaides Pathology handbook for doctors.
|Therapeutic INR ranges||Range of international normalised ratio (INR) recommended for specific applications of warfarin therapy|
|Elevated INR management||Guidelines for the management of an elevated INR, with or without bleeding|
|Warfarin bleeding risks||Risk factors for bleeding complications of Warfarin therapy|