The role of digital health in the management of warfarin therapy
摘要
Warfarin is a commonly prescribed anticoagulant which is indicated for the management of various medical conditions. However, there are challenges associated with warfarin use, such as difficulty in achieving the target international normalized ratio (INR), serious adverse events, and drug and dietary interactions leading to poor patient compliance, which, if not addressed, increase the risk of adverse events and burden on the healthcare system. Warfarin needs regular monitoring owing to its narrow therapeutic index. Digital health may emerge as a promising avenue for warfarin management. Our objective is to review digital health's role in managing warfarin, its limitations, and future directions. Digital healthcare applications can help patients monitor warfarin, increase patient compliance, provide patient education, decrease the need for clinical visits, empower the patient’s participation in their own healthcare, and assist clinicians with decision support, thereby improving outcomes and quality of life. Therefore, this review article is aimed at clinicians, pharmacists, nurses, and researchers involved in managing warfarin. We specifically focus on recent digital technologies that have shown potential for warfarin management such as mobile applications, anticoagulation software, point-of-care and wireless INR devices, artificial intelligence and machine learning, and telehealth. Furthermore, we describe their limitations, relevance to patient care and clinical practice, and future directions.