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Worries on warfarin prompt new advice

The RCGP has released new guidelines on warfarin therapy, following concerns over GPs' increasing responsibilities for anticoagulation monitoring.

The latest edition of In Safer Hands – produced in a link-up with the Government's National Patient Safety Agency – includes a 10-point checklist.

The booklet looks at problem areas such as drug interactions and errors in transcription, handwriting and decimal points. It suggests practices use the Birmingham model, with near-patient testing for INR monitoring and computer software designed for dosing.

The guidance came as a new anticoagulant drug – which will not require monitoring – received approval for use in 14 European countries.

Ximelagatran (Exanta), the first in a new class of drugs called direct thrombin inhibitors, is used in a fixed dose. It has been referred to NICE.

Dr Mayur Lakhani, director of the RCGP quality unit and editor of the booklet, said: 'It's a vulnerable area for the NHS but there is a way forward. The booklet is saying it is OK to do this, it is safe to do this, but you need to do it in a properly managed and resourced way.'

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