{"id":{"repo_id":"cape-town","oai_identifier":"oai:open.uct.ac.za:11427/36043"},"canonical_url":"https://search.dev.ndltd.org/etd/cape-town/oai:open.uct.ac.za:11427/36043","repository":{"repo_id":"cape-town","name":"University of Cape Town","base_url":"https://open.uct.ac.za/oai/request"},"display":{"title":"International normalised ratio control in a non-metropolitan setting in Western Cape Province, South Africa","abstract":"Background: The quality of INR control determines the effectiveness and safety of Warfarin. Data on INR control in non-metropolitan settings of South Africa (SA) is sparse. Objectives: To examine the Time in Therapeutic Range (TTR) and its potential predictors in a sample of Garden Route District Municipality INR clinics Methods: INR records from eight Primary Healthcare Clinics (PHCs) were reviewed. The TTR and percentage of patients with a TTR greater than 65% were determined. A host of variables were analysed for association with TTR. Results: The median age of the cohort of 191 was 56 years (IQR 44-69). The median TTR was 37.17% (IQR 20.21-58.78); only 17.8% of patients had a TTR > 65%. Compared to patients older than 50, those under 50 had worse INR control (TTR 26.63%, IQR 16.05-52.98 vs. 43.5%, IQR 23.52- 60.08, p=0.01). Patients hospitalised for any reason during the study period had worse INR control than patients not hospitalised (TTR 26.23%, IQR 16.24-50.16 vs. 42.89, IQR 23.5-61.95, p=0.02). On multivariable regression analysis, participants on warfarin for atrial fibrillation/flutter had better INR control (OR 2.21, CI 1.02-4.77, p=0.04) but the control was still very poor. Conclusion: INR control as determined by TTR and proportion of TTR >65% in these non-metropolitan clinics was poor. Age and markers of illness predicted poor control. There was a difference in control between groups depending on the indication for warfarin. Evidence-based measures to improve the quality of INR control amongst patients on warfarin therapy need to be instituted as a matter of urgency.","abstract_html":"Background: The quality of INR control determines the effectiveness and safety of Warfarin. Data on INR control in non-metropolitan settings of South Africa (SA) is sparse. Objectives: To examine the Time in Therapeutic Range (TTR) and its potential predictors in a sample of Garden Route District Municipality INR clinics Methods: INR records from eight Primary Healthcare Clinics (PHCs) were reviewed. The TTR and percentage of patients with a TTR greater than 65% were determined. A host of variables were analysed for association with TTR. Results: The median age of the cohort of 191 was 56 years (IQR 44-69). The median TTR was 37.17% (IQR 20.21-58.78); only 17.8% of patients had a TTR > 65%. Compared to patients older than 50, those under 50 had worse INR control (TTR 26.63%, IQR 16.05-52.98 vs. 43.5%, IQR 23.52- 60.08, p=0.01). Patients hospitalised for any reason during the study period had worse INR control than patients not hospitalised (TTR 26.23%, IQR 16.24-50.16 vs. 42.89, IQR 23.5-61.95, p=0.02). On multivariable regression analysis, participants on warfarin for atrial fibrillation/flutter had better INR control (OR 2.21, CI 1.02-4.77, p=0.04) but the control was still very poor. Conclusion: INR control as determined by TTR and proportion of TTR >65% in these non-metropolitan clinics was poor. Age and markers of illness predicted poor control. There was a difference in control between groups depending on the indication for warfarin. Evidence-based measures to improve the quality of INR control amongst patients on warfarin therapy need to be instituted as a matter of urgency.","abstract_has_math":false,"creators":["Prinsloo, Dawid Nicolaas"],"institution":"Department of Medicine","degree_name":null,"degree_level":null,"degree_discipline":null,"degree_department":null,"school":null,"contributors":[],"advisors":["Ntsekhe, Mpiko","Gould, T J"],"committee_chairs":[],"committee_members":[],"year":2021,"date_issued":"2021","date_published":"2021","updated_at":"2026-07-22T22:23:01Z","subjects":["Medicine"],"languages":[],"rights":[],"rights_urls":[],"identifier_entries":[]},"links":{"outbound_url":"http://hdl.handle.net/11427/36043","outbound_label":"Handle","outbound_source":"dc:identifier.uri"},"metadata_groups":[{"id":"people","label":"People","entries":[{"key":"dc:contributor.advisor","label":"Advisor","values":["Ntsekhe, Mpiko","Gould, T J"]},{"key":"dc:creator","label":"Author","values":["Prinsloo, Dawid Nicolaas"]}]},{"id":"academic_context","label":"Academic Context","entries":[{"key":"dc:date.accessioned","label":"Dc Date Accessioned","values":["2022-03-10T14:05:17Z"]},{"key":"dc:date.available","label":"Dc Date Available","values":["2022-03-10T14:05:17Z"]},{"key":"dc:date.issued","label":"Date","values":["2021"]},{"key":"dc:publisher.department","label":"Dc Publisher Department","values":["Department of Medicine"]},{"key":"dc:type","label":"Dc Type","values":["Master Thesis"]},{"key":"dc:type.qualificationlevel","label":"Dc Type Qualificationlevel","values":["Masters","MMed"]}]},{"id":"subjects_keywords","label":"Subjects and Keywords","entries":[{"key":"dc:subject","label":"Dc Subject","values":["Medicine"]}]},{"id":"identifiers","label":"Identifiers","entries":[{"key":"dc:identifier.uri","label":"Identifier URI","values":["http://hdl.handle.net/11427/36043"]}]},{"id":"additional","label":"Additional Metadata","entries":[{"key":"dc:description.abstract","label":"Abstract","values":["Background: The quality of INR control determines the effectiveness and safety of Warfarin. Data on INR control in non-metropolitan settings of South Africa (SA) is sparse. Objectives: To examine the Time in Therapeutic Range (TTR) and its potential predictors in a sample of Garden Route District Municipality INR clinics Methods: INR records from eight Primary Healthcare Clinics (PHCs) were reviewed. The TTR and percentage of patients with a TTR greater than 65% were determined. A host of variables were analysed for association with TTR. Results: The median age of the cohort of 191 was 56 years (IQR 44-69). The median TTR was 37.17% (IQR 20.21-58.78); only 17.8% of patients had a TTR > 65%. Compared to patients older than 50, those under 50 had worse INR control (TTR 26.63%, IQR 16.05-52.98 vs. 43.5%, IQR 23.52- 60.08, p=0.01). Patients hospitalised for any reason during the study period had worse INR control than patients not hospitalised (TTR 26.23%, IQR 16.24-50.16 vs. 42.89, IQR 23.5-61.95, p=0.02). On multivariable regression analysis, participants on warfarin for atrial fibrillation/flutter had better INR control (OR 2.21, CI 1.02-4.77, p=0.04) but the control was still very poor. Conclusion: INR control as determined by TTR and proportion of TTR >65% in these non-metropolitan clinics was poor. Age and markers of illness predicted poor control. There was a difference in control between groups depending on the indication for warfarin. Evidence-based measures to improve the quality of INR control amongst patients on warfarin therapy need to be instituted as a matter of urgency."]},{"key":"dc:title","label":"Title","values":["International normalised ratio control in a non-metropolitan setting in Western Cape Province, South Africa"]}]}],"canonical_facts":{"dc:contributor.advisor":["Ntsekhe, Mpiko","Gould, T J"],"dc:creator":["Prinsloo, Dawid Nicolaas"],"dc:date.accessioned":["2022-03-10T14:05:17Z"],"dc:date.available":["2022-03-10T14:05:17Z"],"dc:date.issued":["2021"],"dc:description.abstract":["Background: The quality of INR control determines the effectiveness and safety of Warfarin. Data on INR control in non-metropolitan settings of South Africa (SA) is sparse. Objectives: To examine the Time in Therapeutic Range (TTR) and its potential predictors in a sample of Garden Route District Municipality INR clinics Methods: INR records from eight Primary Healthcare Clinics (PHCs) were reviewed. The TTR and percentage of patients with a TTR greater than 65% were determined. A host of variables were analysed for association with TTR. Results: The median age of the cohort of 191 was 56 years (IQR 44-69). The median TTR was 37.17% (IQR 20.21-58.78); only 17.8% of patients had a TTR > 65%. Compared to patients older than 50, those under 50 had worse INR control (TTR 26.63%, IQR 16.05-52.98 vs. 43.5%, IQR 23.52- 60.08, p=0.01). Patients hospitalised for any reason during the study period had worse INR control than patients not hospitalised (TTR 26.23%, IQR 16.24-50.16 vs. 42.89, IQR 23.5-61.95, p=0.02). On multivariable regression analysis, participants on warfarin for atrial fibrillation/flutter had better INR control (OR 2.21, CI 1.02-4.77, p=0.04) but the control was still very poor. Conclusion: INR control as determined by TTR and proportion of TTR >65% in these non-metropolitan clinics was poor. Age and markers of illness predicted poor control. There was a difference in control between groups depending on the indication for warfarin. Evidence-based measures to improve the quality of INR control amongst patients on warfarin therapy need to be instituted as a matter of urgency."],"dc:identifier.uri":["http://hdl.handle.net/11427/36043"],"dc:publisher.department":["Department of Medicine"],"dc:subject":["Medicine"],"dc:title":["International normalised ratio control in a non-metropolitan setting in Western Cape Province, South Africa"],"dc:type":["Master Thesis"],"dc:type.qualificationlevel":["Masters","MMed"]},"updated_at":"2026-07-22T22:23:01Z"}