Adherence to Anticoagulation Ambulatory during the Beginning of Coronavirus Pandemic

INTRODUCTION: Treatment with Vitamin K Antagonists is already proven to be significant in reducing thromboembolic events in patients with indications for systemic anticoagulation. In the context of ambulatory adherence, the SARS-CoV2 coronavirus pandemic emerged as a challenge for managing patients undergoing anticoagulation.

METHODS: To avoid crowding and follow the recommended measures of social distancing, the Anticoagulation Ambulatory of the Hospital Universitário de Santa Maria started to adopt a differentiated model of care, with a collection of hospital prothrombin time and immediate home return, followed by teleconsultation, with medication adjustment, as necessary. The present study aimed to assess adherence to the new care model, as well as the profile of patients seen. A retrospective cohort study was conducted, analyzing consultations between March and May 2020.

RESULTS: The results demonstrate a low-educated population (76% had completed elementary school at most). The most common indications for the use of oral anticoagulation were atrial fibrillation (33.6%), followed by mechanical aortic valve prosthesis (31.3%) and mechanical mitral valve prosthesis (17.2%). Regarding adherence, especially to blood collection in the scheduled period, there was low adherence in the initial weeks of the pandemic declaration, with substantial improvement in adherence in the last two weeks of analysis.

CONCLUSION: Determining the clinical characteristics and profile of patients helps to determine the local needs of this population and implement active search strategies to improve adherence rates, which may reduce unfavorable outcomes.