More frequent international normalized ratio (INR) monitoring of hospitalized patients taking the anticoagulant warfarin could increase patient safety, according to a study published online Dec. 14, 2015 in the Journal of Hospital Medicine. Specifically, the authors say, daily INR measurement and recognition of a rapidly rising INR could decrease the frequency of warfarin-associated adverse events. Warfarin is one of the most common causes of adverse drug events, yet there is limited evidence to guide appropriate warfarin monitoring frequency for hospitalized patients. In 2015, the Joint Commission (JC) reissued its anticoagulant-focused National Patient Safety Goal, which mandates the assessment of baseline coagulation status before starting warfarin, and calls for warfarin dosing based on a "current" INR, although current is not defined. In the present study, the researchers retrospectively analyzed Medicare Patient Safety Monitoring System data to identify patients hospitalized from 2009 to 2013 for pneumonia, acute cardiac disease (myocardial infarction or heart failure), or surgery, who received warfarin. If a patient’s INR level never reached above 1.5, they were excluded from analysis. The researchers identified 14,217 patients, of whom 1,055 (7.4 percent) developed a warfarin-associated adverse event. Warfarin treatment was started on the first day of hospitalization for 6,825 patients (48.0 […]