Partitioning tablets: A risky business

Abstract

The oral anticoagulant most often administered in Indonesia is warfarin. Nevertheless, TTR is
consistently low among nations throughout the globe. The purpose of this research was to examine
the obstacles to optimum warfarin control. There were two separate phases of the study. A
prospective observational research was conducted in the first stage to examine factors such as
anticoagulation control, dosage consistency, compliance with INR monitoring, medication
adherence, and awareness of warfarin. In the meanwhile, solutions to the problems were proposed
in the second stage via focus groups. Based on the findings, the mean TTR was 49.4 ± 32.1, with only
37.5% of patients achieving values of 65% or above. On average, 62.33 ± 32.42% of the doses were
consistently administered. A one-month delay between dosage adjustments was necessary for most
individuals with supratherapeutic INR levels. Further investigation revealed that only 43.8% of
patients were deemed to be adherent, and only 39.5% had excellent understanding of warfarin. This
indicates that the degree of drug adherence and knowledge was subpar. In around 14.6 percent of
patients, other medications were prescribed that may have interacted with warfarin and caused INR
variations. Findings from this research point to a number of obstacles that patients have while trying
to achieve optimum warfarin management, such as difficulties with dosage consistency, monitoring
INR, taking medications as prescribed, and understanding the medicine and its interactions. A
comprehensive strategy integrating several tactics to overcome each obstacle is the recommended
course of action.