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Topics in this Dawn AC E-Newsletter              Previous Newsletters

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Topics in this Dawn AC E-Newsletter

• Dawn AC Version 6.10 Upgrade now available

•  Outcomes in a Centralised Pharmacy Service

• Important Safety Information on using Interfaces to Dawn AC

• Dawn AC Benchmarking Scheme - last call for participants.

• 13^th Dawn AC User Group 21/22^nd November 2005

• Forthcoming Meetings

 Dawn AC Version 6.10 Upgrade now available

Version 6.10 upgrade is now available at http://www.4s-dawn.com/dawnac  for those on Version 6.03 or later. Look under latest news for a link to the upgrade download page.

Since version 6.06 was made available for downloading, there have been many significant changes to Dawn AC. Here is a summary of the improvements:

• The way logins are recorded and released has been completely redesigned. This should remove problems with resetting users and '4Slocks'. There are also improvements in the method of checking whether other users are logged in when performing Database Maintenance or when taking or restoring a snapshot.
• When dosing individually within the batch screen (Not available in Practitioner version), the way the next patient is selected from the list has been streamlined to speed up the process of working through the batch list and reviewing patients.
• Various improvements have been made to prevent problems if treatment information is edited by double-clicking on the treatment history list. The information printed out in user letters will now include changes made to the treatment history by adding history, editing or deleting treatment records.
• Organisations can now be linked to health authorities, to enable the recording of a GP surgery's PCT and this can be reported on via the ad hoc report writer.
• Numerous enhancements have been made to the Word Link, including:
  • the handling of international characters in patient demographics and fractions in dosing instructions
  • additional mail merge fields, such as Next Test Date (for both timed and non-timed appointments) and National Number
  • easier use on a network, removing the need for any special installation steps and allowing Word to be installed in different locations on different workstations
  • using Word forms to capture data and to save them into patients' clinic notes

Please note you should only upgrade your Practice system first and familiarise yourselves with the changes, before going live with version 6.10.

Outcomes in a Centralised Pharmacy Service

Dawn AC users, Dan Witt et. al. from Kaiser Permanente of Colorado have published a study in CHEST 2005; 127:1515-1522, May 2005 that concludes that a centralised, telephonic, pharmacist-managed, (Dawn AC aided service) (CPAS) reduced the risk of therapy related complications compared to that of the usual physician care (control group). This paper has many vital gems of information and well worth studying. Here are some highlights:

The CPAS patients were 39% less likely to experience complications. The CPAS group spent 63.5% of time within therapeutic range against 55.2% in the control group (p <0.001).  The CPAS patients (n=3323) had 1% patient years thromboembolic event incidence rate compared to 3% patient years from the control group (n=3322).

Important Safety Information on using Interfaces Module to Dawn AC

To guard against the accidental importing or matching of old results to patients, a feature was added to the product in 2002 to allow matching on sample date. With this option enabled, results are automatically rejected if the sample date (imported with the INR) does not match the current clinic date.

In 2002, we urged all sites to implement it as a significant safety enhancement.  However, some sites continue to rely on manual methods for preventing such potential problems. While manual procedures may prove adequate when followed routinely by experienced staff, you must consider whether they are robust enough to provide protection when the service is being temporarily run by less experienced staff covering absence or at times of exceptional throughput or disruption. If have not already implemented this feature, we strongly recommend that you do so now. 

More details on this key safety topic with a simple questionnaire to help you decide what is most appropriate for your local configuration is available at 

http://www.4s-dawn.com/dawnac/interfacesampledate.htm

The fourteenth run of the Dawn AC Benchmarking scheme is currently underway.  In the last run 75 centres with 177,000 patients and 1,350,000 INRs were analysed across four target ranges. A comprehensive report is produced, profiling your centre in detail and comparing it anonymously with other centres.   

The report includes information on numbers and patients and INRs, % Time in Range and % INRs in Range, mean interval, dose, dose intervention etc.  An example copy of the report is available from our web-site.

The analysis occurs twice a year and the annual cost of the scheme is £350 plus VAT.  If you do not already participate and would like to join the scheme it is not too late to do so.  If you can e-mail or fax to us a purchase order confirming your intention to participate in the scheme by June 13th then we will be able to include you in this run.

13^th Dawn AC User Group 21/22^nd November 2005

We are in the process of planning the 13^th Annual User Group conference in the Lake District.

We are pleased to announce that Dan Witt from Kaiser Permanente will be speaking on the above outcomes study

If you would like to present a short talk on your use of Dawn AC or on a related anticoagulation matter at the meeting please let me know. Speakers are given a discount on the cost of the conference.

If you are attending the following meetings would be pleased to see you.

American Society of Health Systems Pharmacists, Boston,  USA, 13^th to 15^th June 2005 on Booth 551.

International Society of Haemostasis and Thrombosis, Sydney, Australia, 8th to 11^th August 2005 on Booth 502.

Syd Stewart

End of Newsletter

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