Anticoagulation Clinic
The Anticoagulation Clinic (previously the Warfarin Clinic) at the Bon Secours Hospital Dublin opened in 2008. It is a welcoming unit and an integral part of the cardiology services within the hospital.
The aim of the Clinic is to educate new and review existing patients in understanding their indication for therapy, their target range for INR, the effects of over and under anticoagulation, diet, lifestyle and drug interactions. It also advises on anticoagulant therapy regime prior to surgery or dental care.
Dosing of anticoagulants can be challenging as there is a wide variation in how a patient’s body will respond. Variations in a gene involved in blood clotting can cause the medication to be highly effective in some people while, in others, the same dose may result in serious side effects. Patients taking anticoagulants should have their INR measured regularly. More frequent tests are needed when patients start, stop or alter the dose of their other medications.
The INR is estimated using a Point of Care device and a finger-prick sample which gives results instantly (3 minutes approximately). The results are interpreted and as required anticoagulant dosage may be adjusted in consultation with relevant Medical Personnel.
Quality
The Clinic is committed to adhering to best practice and quality control. Internal quality control is performed at the start of each clinic. External quality assessment is completed every three months using samples from UK NEQAS based in the Royal Hallamshire University Hospital, Sheffield UK and currently there are close on 4000 analysers registered with them.
All Clinic staff have undertaken accredited courses in the management of oral anticoagulants and are supported by the Haematology laboratory staff.
Referrals
Patients who attend our Anticoagulation Clinic are referred either by their consultant physician / Cardiologist and / or by their GP. For GP referrals, the patient must be under the care of a consultant who attends the Bon Secours Hospital Dublin.
Where patients are being referred from another hospital or clinic a Consultant’s letter must accompany the patient stating clinical indication, target INR and recommended period of therapy.
Patients attending other anticoagulation clinics will also be accepted for monitoring until their INR stabilises. This would occur in cases where as an in-patient anticoagulant therapy was held for any invasive procedure.
All new patient referrals to the clinic must be in writing and forwarded to The Anticoagulation Clinic c/o St Brigid's Ward. Subsequent appointments to attend the clinic will be arranged by our team.
The clinic is not in a position to accept the following:
- Patients under 16 yrs of age
- Patients with complex pathologies e.g. atypical systemic emboli, anything not listed under routine indications for Warfarin
- Pregnant patients
- Domiciliary patients
The Anticoagulation clinic provides a nurse-led service on the following days:
- Tuesday and Wednesday - 7.15am to 3.45pm
- Friday - 7.30am to 11.30pm
For urgent cases, appointments may be arranged outside of the above hours by calling St Brigid's ward on 01 806 5493.
