SmartWarf - A Portable Automated Warfarin Dosing Tool

摘要

Warfarin is the most frequently prescribed oral anticoagulant and the second most common drug implicated in emergency room visits for adverse drug events. At present, the appropriate dose of warfarin is usually determined empirically on an individual basis by measuring patient response, which has up to 60-fold variation among individuals. It is now understood that patient demographics and genetic variability result in significant differences in warfarin doses required for effective and safe treatment. To help the clinician to calculate a patient-specific dose in real time based on the clinical and genotyping data, we developed SmartWarf, a user-friendly portable tool to help individualize warfarin dosing and follow-up. SmartWarf works in a personal digital assistant (PDA) or desktop computer and allows for the clinician to input and update the clinical data and results of the genetic tests. SmartWarf applies a dosing algorithm to calculate the dose and dose interval for the patient. Actual dosing prescribed and follow-up warfarin care are inputted into the PDA which is synchronized with either a hospital/physician office SmartWarf database or with a national core SmartWarf database. In the server environment, a centralized database stores the predicted and actual warfarin doses as well as patient's de-identified clinical and genetic data. The SmartWarf technology provides a real time and portable medical data transmission and handling tool.