Study helps minority patients manage common blood thinner
Minority patients trying to self-manage their health with the blood-thinning drug warfarin face difficulties, and researchers at the University of Illinois at Chicago College of Pharmacy are trying to help overcome them.
A four-year $527,000 federal grant will allow Edith Nutescu, professor of clinical pharmacy and clinical director of UIC’s Antithrombosis Center, to investigate why minority patients often do poorly on warfarin therapy. She will use focus groups to develop self-management programs that enable patients to be active participants in their own care.
The nearly 3 million patients taking warfarin in the U.S. require frequent monitoring and dosing adjustments due to the narrow range between therapeutic and toxic doses of the drug and the variable response of the individual patient, Nutescu said. If patients don’t manage warfarin properly, she said, blood clots or major bleeding can lead to hospitalization–or death.
Prior studies have shown that minority populations, especially African Americans and Hispanics, tend to be at higher risk–because of difficulty traveling to a health care facility, longer clinic wait times, financial constraints, or lack of knowledge about their condition, Nutescu said.
“We recognize that these issues are not unique to minorities, but based on our clinical experience and preliminary data, our inner-city, minority patients represent a low socioeconomic group that experiences a disproportionate amount of these issues,” Nutescu said.
“Instituting accessible and convenient options to improve anticoagulation control is important to these patients.”
Poorer dosage control in minority patients is due to variable adherence and access to specialized care, Nutescu said. To improve the quality and safety of anticoagulation therapy, patients need to be active participants in their care.
“Self-monitoring offers the advantage of patient convenience, by allowing them to test at home and avoid the need for frequent laboratory and clinic visits,” Nutescu said. But despite favorable results seen in home-testing, its adoption by minority patients has been limited.
The research is a first step in reducing health disparities in thrombosis patients, Nutescu said, and will serve as a model of self-care for other health conditions in high-risk patients.
Grant K23HL1 12908 is from the National Heart, Lung and Blood Institute, one of the National Institutes of Health.