Haematologica 2004;89: supplement no. 8 - Supplements ...

XVIII Congress of the Italian Society for Hemostasis and Thrombosis Research, Rome, Sept. 30-Oct. 3, 2004183different combinations of reagent/instrument used.Data are classified as: A if they are between ±1 Z-score, B if between ±2 Z-score, C if between ±3 Z-score and D if above/below 3 Z-score or outliers. Participantsare immediately contacted if results arepersistently (3 consecutive exercises) above the fixedacceptable limits (± 1 Z-score). Elaboration of datafrom 1990 to 2003 shows that labs with consistentparticipation have consistent and statisticallyimprovement in performance. In 2003 80% of allparticipant labs showed results in class A. Data alsosuggest that labs with more experience with proficiencytesting have lower rate of unacceptableresults and that this rate tends to decrease with eachyear of experience. These conclusions support thefindings of other researchers who have documentedthe benefits of inter-laboratory comparison programsand proficiency testing.PO-174ISAM: INTERNATIONAL STUDY OF ANTICOAGULATIONMANAGEMENT. THE ITALIAN EXPERIENCEPengo V, 1 Adriani C, 1 Alatri A, 2 Antonucci E, 3Baudo F, 4 Caimi TM, 4 Cauli C, 5 Lopatriello S, 6Malato A, 7 Manotti C, 8 Marongiu F, 5 Negrini C, 6Poli D, 3 Siragusa S, 7 Tassoni MI, 8 Testa S, 2 Attinà G 91Dip. di Medicina Clinica e Sperimentale, Sezione diCardiologia, Ospedale di Padova; 2 Centro Emostasie Trombosi, Istituti Ospedalieri, Cremona; 3 Dip. delCuore e dei Vasi, Unità di Malattie Aterotrombotiche,Azienda Ospedaliera-Universitaria Careggi,Florence; 4 Strutt. Compl. di Ematologia, OspedaleNiguarda-Cà granda-Milano; 5 Cattedra di MedicinaInterna, Policlinico Universitario di Monserrato,Università di Cagliari; 6 PBE Consulting S.r.L, Milano;7Cattedra di Ematologia dell'Università di Palermo;8Centro Emostasi, Ospedale Maggiore di Parma;9Economic Affairs, AstraZeneca Italia; ItalyObjectives. ISAM, a multicenter, observational, retrospective,cross-sectional study, aimed at describingthe anticoagulation treatment monitoring onpatients with chronic non-valvular atrial fibrillation(CNVAF) for stroke prophylaxis (follow-up: Jan-Dec2002); and estimating the direct and indirect costsassociated with Oral Anticoagulation Therapy (OAT)according to the Italian National Health System perspective.Methods. 7 out of 8 AntiCoagulation Clinics(ACCs), selected to represent the whole Italianterritory, enrolled 23 randomized patients withCNVAF. Results. The total number of patients was177: 102 were males and 75 females (mean age 72years); 90% was affected by chronic Atrial Fibrillationand 10% by paroxysmal. 77% received warfarinand 23% acenocumarol. Only 18% had no risk factors,64% had hypertension, 12% diabetes, 32% previousthromboembolic events, 24% coronary arterydisease and 12% congestive heart failure. Everypatient had on average 19 INR tests per year (meanfrequency: every 20 days); 40% of total tests (3168)required dosage changes and 73% were in the recommendedrange (2.0-3.0) anyway. Quality of OATmonitoring, according to Rosendaal's method, was:67.9% of time was spent in the range 2.0-3.0, 21%below and 10% above this range. Total cost perpatient per year was 943 : 745 ¤ direct costs and198 ¤ indirect ones (productivity loss by patients ortheir caregivers). Medical costs, 525 ¤, included OA Tdrug (5%), INR tests (18%) monitoring visits (44%)and admissions (33%). Non-medical costs (transportation)amounted to 220 . Conclusions. Patientsin ACC management could obtain good level of INRcontrol: Time in Target Range 67.9%, comparablewith other literature findings. ISAM is a first attemptto measured the resource consumption generated bythe monitoring system (ACCs) associated with a goodlevel of control, and whose costs include drugs, INRtests and monitoring visits, which are the majorcomponents of such costs.haematologica vol. 89(suppl. n. 8):september 2004