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Background <p>Achieving stable anticoagulation with warfarin remains challenging in older adults, who are particularly vulnerable to both thromboembolic and bleeding complications. Despite continued reliance on warfarin in this population, anticoagulation quality has not been comprehensively synthesized. This systematic review evaluated anticoagulation quality among older adults receiving warfarin, focusing on time in therapeutic range (TTR) and international normalized ratio (INR) distribution patterns.</p> Methods <p>PubMed/MEDLINE and Web of Science were systematically searched from January 2000 to August 2025 to identify studies including adults aged ≥ 60 years receiving warfarin and reporting TTR. This review was registered in PROSPERO (CRD420251270126).</p> Results <p>Twelve studies (2 randomized and 10 observational) were included. Observational studies reported variable and frequently suboptimal anticoagulation control (TTR 42.6–78.6%), whereas pharmacist-led management and genotype-guided dosing improved TTR (93% vs. 31.2% and 70.8% vs. 53.44%, respectively).</p> Conclusions <p>Anticoagulation quality among older adults receiving warfarin remains frequently suboptimal in routine clinical practice. Evidence suggests improved anticoagulation control with structured, individualized management strategies.</p>

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Evaluation of Anticoagulation Quality Among Older Adults Receiving Warfarin: A Systematic Review

  • 期刊论文

  • 发表日期：

    2026年6月20日

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  • Raghad Alrashidi,
  • Renad Alhaqbani,
  • Mohammed M. Alharbi,
  • Abdulmajeed Alshehri,
  • Majed S. Al Yami

摘要

Background

Achieving stable anticoagulation with warfarin remains challenging in older adults, who are particularly vulnerable to both thromboembolic and bleeding complications. Despite continued reliance on warfarin in this population, anticoagulation quality has not been comprehensively synthesized. This systematic review evaluated anticoagulation quality among older adults receiving warfarin, focusing on time in therapeutic range (TTR) and international normalized ratio (INR) distribution patterns.

Methods

PubMed/MEDLINE and Web of Science were systematically searched from January 2000 to August 2025 to identify studies including adults aged ≥ 60 years receiving warfarin and reporting TTR. This review was registered in PROSPERO (CRD420251270126).

Results

Twelve studies (2 randomized and 10 observational) were included. Observational studies reported variable and frequently suboptimal anticoagulation control (TTR 42.6–78.6%), whereas pharmacist-led management and genotype-guided dosing improved TTR (93% vs. 31.2% and 70.8% vs. 53.44%, respectively).

Conclusions

Anticoagulation quality among older adults receiving warfarin remains frequently suboptimal in routine clinical practice. Evidence suggests improved anticoagulation control with structured, individualized management strategies.