Effect of an interactive voice response system on oral anticoagulant management

Area of Science:

• Pharmacology and Therapeutics
• Health Informatics
• Patient Monitoring Systems

Background:

• Oral anticoagulant monitoring presents significant logistical challenges for patients and healthcare providers.
• Computerized decision support systems aid in managing oral anticoagulants, but integration with patient communication can be improved.

Purpose of the Study:

• To evaluate the impact of integrating an interactive voice response (IVR) system with existing computerized decision support for oral anticoagulant management.
• To assess the effect of the IVR system on patient adherence, anticoagulation control, and healthcare staff workload.

Main Methods:

• An IVR system was developed to deliver international normalized ratio (INR) test results and warfarin dosage schedules to patients.
• The system also provided reminders for upcoming and missed blood test appointments.
• Stable warfarin patients (n=226) were prospectively monitored for at least 3 months, with retrospective data collected for the preceding 3 months.

Main Results:

• Anticoagulation control, measured by time within the therapeutic range (TTR), remained similar during the intervention (80.3%) and pre-intervention (79.9%) periods.
• The IVR system successfully delivered 77.8% of scheduled dosage messages without requiring additional clinic staff input.
• Patient preference for continuing IVR use was high (76.6%), and the system reduced staff workload by 33% (48 min/wk).

Conclusions:

• Interactive voice response systems demonstrate potential for enhancing the monitoring of patients on oral anticoagulant therapy.
• The IVR system effectively maintained anticoagulation control while significantly reducing the burden on clinical staff.
• Further research is necessary to establish the generalizability and cost-effectiveness of IVR systems in anticoagulation management.