Summary
There is an increasing use of computer-based dosage programs to monitor oral anticoagulant
therapy in outpatients. DAWN AC INDUCTION by 4S, UK, is a computer generated system
to initiate oral anticoagulant therapy providing fast access to the maintenance program.
This method of initiation of anticoagulant therapy has not been validated. We therefore
randomized 50 hospitalized patients starting oral anticoagulation to control by the
computer and 51 by manual dosing using a dosing schedule based on a locally defined
algorithm. After a 7 days follow up, the daily mean INR was 2.09 and 2.07 and the
proportion of dose adjustments was 48% and 45% in the computer and manually controlled
groups respectively. Twenty-eight % of the patients monitored by the computer system
required at least one manual overriding. DAWN AC INDUCTION provided a simple and accurate
organization of the data, with an overall quality comparable to that of the manual
system. Furthermore, the induction programme provided simple access to the maintenance
programme. Although it required careful monitoring, the programme resulted in a significant
saving in personnel time.
Key words
Warfarin - computer management
