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E-Newsletter November 2006

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 DAWN AC Anticoagulation Software E-Newsletter
November 2006 
  IN THIS ISSUE
 
  • Latest News for DAWN
  • V7 Developments 
  • Benchmarking
  • 'One Size Fits Few'
  • Vitamin K Supplements
  •  

    Welcome to the November 2006 edition of the DAWN AC Anticoagulation Software E-Newsletter.
     
    There are some exciting new developments on the horizon which this month's newsletter focuses on. 

     

     
     Latest News for DAWN 

    Our NEW Website

     

    This month we launched the new Dawn AC website. We feel the website should now be more user friendly for our customers, and comments so far on the new design have been extremely positive!

     

    Why not visit our website to download our V7 User Manual Sampler or to look at our Quality of Care Download

     

    To see the new website please follow this link:

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

     

    User Group Write Up's

     

    The power points of the presentations from the User group are also on the website now for people to look at http://www.4s-dawn.com/dawnac/ugppts2006.htm 

     

    The written proceedings of the 2006 conference will soon be ready to send out. Please e-mail sales@4s-dawn.com if you would like to request a copy of these proceedings to be sent to you.

    Version 7 Developments... (1050) coming soon...
    The new web browser based Version 7 has seen a hugely successful year. DAWN AC now has over 40 customers using V7.
     
    Next Release of V7 (1050)
     
    V7 (1050) is due to be released soon, many improvements have been made including:
    • Improved alerting for drugs/procedures/reminders and events
    • Ability to send adhoc e-mails/phone messages and faxes
    • New message events allows you to put a patient on a phone list if their INR has triggered a dose change, or have different message options for patients with dose changes or without.
    • Can now filter on dose changes in list views
    • Can now direct specific messages to different healthcare professional roles i.e. standing order to Lab or copy a dosing instruction to the high street pharmacy.

    ADT Interface Module

    In the next release of the interface module you will be able to alert users to patient admissions and discharges, enabling you to track your patients whilst they are in hospital.

    DAWN AC Benchmarking Service & New BCSH Safety Guidelines

    The 12th run of the Benchmarking is currently taking place. The primary focus of our Benchmarking Service is to provide a forum for benchmarking of pertinent operational and clinical performance or outcome measures indicators to support and enhance the clinical practice of each member organisation.

     

    It enables your organization to identify areas for improvement and provide a means of continuously monitoring progress in these areas.

     

    There are new recommendations from the Bristish Commitee for Standards in Haematology (BCSH) & National Patient Safety Agency (NPSA) issuing safety indicators for inpatient and outpatient oral anticoagulant care. We are considering modifying the Benchmarking Report to include these safety indicators. Please see the following site for more details and lists of recommendations and indicators:

    http://www.bcshguidelines.com/pdf/Anticoagulant_310806.pdf

    'One Size Fits Few'
     
    Every day millions of people take warfarin or Coumadin, powerful drugs used to control life threatening conditions. How much of these medicines people need is difficult to determine and often it takes several months of weekly clinic visits and blood tests.

    According to the FDA, hemorrhage during warfarin therapy is a leading cause of death in Western countries and related adverse events account for 1 in 10 hospital admissions.
     
    The quality of Anticoagulaiton care is generally poor despite INR monotoring, however, two methods can be adopted to improve the patients time in range, by the induction phase (monitoring the patient regularly to ensure they get in range quickly) and the maintenance phase ensuring stable dosing (which is adjusted when needed on changes in co-varieties), and constant monitoring. Both of these phases can be aided by the Dawn AC software. For more information on our Induction Module, or our software as a whole, please contact sales@4s-dawn.com
     
    Thankfully, recent discoveries in DNA research make predicting the dose of warfarin a person needs much more accurate, and of equal importance, how long it takes them to eliminate the drug. More than half the population have variations in at least one of the two genes that are tested. These genetic variations are responsible for almost half of the individual variation seen in warfarin dose.

    Here's what a blue ribbon FDA advisory panel has to say about the genetics of warfarin/Coumadin:
     
    • Use lower doses of warfarin for patients with genetic variations in CYP2C9 and or VKORC1 that lead to reduced activities.
       
    • Genotyping patients at the begining of warfarin therapy would reduce adverse events and improve achievement of stable INR.
       
    • Existing evidence of the influence of CYP2C9 and VKORC1 genotypes warrants re-labeling of warfarin to include genetic test information.

    The FDA and others are sponsoring clinical trials to prove the extent to which using DNA testing will reduce adverse bleeding events and save money. Many scientists believe that the use of this testing will dramatically improve Warfarin efficacy and safety.

    To read more of this article, please follow this link: http://www.healthanddna.com/warfarin.html

     

    Vitmamin K Supplements Could Improve Anticoagulation Control

    Reseachers from Newcastle University and the Royal Victoria Infirmary, Newcastle, have built on previous research that reported that unstable control of anticoagulationn is linked to low vitamin K intake (Thrombosis & Haemostasis, Vol. 93, pp. 872-875).

    “We hypothesised that supplementation with oral vitamin K would improve stability in patients with previously unstable control of anticoagulation,” explained lead author Elizabeth Sconce in the journal Blood.

    “Concomitant supplementation of vitamin K, perhaps through reducing the relative day-to-day variability in dietary vitamin K intake, can significantly improve anticoagulation control in patients with unexplained instability of response to warfarin,” said the researchers.

    The research culd also have benefits on a wider scale, they said, by reducing the frequency of visits to monitor a patient's control, reducing the associated costs of medication, and improving a patient's quality of life.

    Source: Blood First Edition Paper
    Published online ahead of print, doi 10.1182/blood-2006-09-049262
    “Vitamin K supplementation can improve stability of anticoagulation for patients with unexplained variability in response to warfarin” Authors: E. Sconce, P. Avery, H. Wynne, and F. Kamali
     

     
     
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