The objective of this report is to provide recommendations for the optimal management of warfarin for the prevention of thromboembolic events in patients with atrial fibrillation (AF). Three specific questions were asked to CADTH COMPUS Expert Review Committee (CERC) members:

• Question 1: What is the role of specialized anticoagulation services or other anticoagulation management options for the optimal management of warfarin therapy?
• Question 2: What is the role of patient self-testing and patient self-management for the optimal management of warfarin therapy?
• Question 3: In remote areas, what types of anticoagulation management options can be recommended?

Contents

• 1. INTRODUCTION
  • 1.1 COMPUS Expert Review Committee
• 2. ISSUE
  • 2.1 Atrial Fibrillation
  • 2.2 Technology Description
• 3. OBJECTIVE
• 4. PROJECT OVERVIEW
• 5. RESULTS
  • 5.1 Optimal Management Recommendations
  • 5.2 Research Gaps
• 6. THE EVIDENCE
• 7. CONSIDERATION OF THE EVIDENCE
  • 7.1 COMPUS Expert Review Committee Process and Perspective
• 8. NEXT STEPS
• APPENDIX A EXPERT COMMITTEE AND CONTRIBUTORS
• APPENDIX B COMPUS EXPERT REVIEW COMMITTEE DELIBERATION PROCESS AND INTERPRETATION OF FINDINGS
• APPENDIX C COMPUS EXPERT REVIEW COMMITTEE VOTING PROCESS
• APPENDIX D ABBREVIATIONS
• REFERENCES

This report is prepared by the Canadian Agency for Drugs and Technologies in Health (CADTH). This report contains a review of existing public literature, studies, materials, and other information and documentation (collectively the “source documentation”) available to CADTH at the time it was prepared, and it was guided by expert input and advice throughout its preparation.

The information in this report is intended to help health care decision-makers, patients, health care professionals, health systems leaders, and policy-makers make well-informed decisions and thereby improve the quality of health care services. The information in this report should not be used as a substitute for the application of clinical judgment in respect to the care of a particular patient or other professional judgment in any decision-making process, nor is it intended to replace professional medical advice. While CADTH has taken care in the preparation of this report to ensure that its contents are accurate, complete, and up-to-date, CADTH does not make any guarantee to that effect. CADTH is not responsible for any errors or omissions or injury, loss, or damage arising from or as a result of the use (or misuse) of any information contained in or implied by the information in this report.

CADTH takes sole responsibility for the final form and content of this report. The statements, conclusions, and views expressed herein do not necessarily represent the view of Health Canada or any provincial or territorial government.

Production of this report is made possible through a financial contribution from Health Canada.