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. 2017 Oct 4;2017(10):CD003942. doi: 10.1002/14651858.CD003942.pub3

Ibrahim 2013.

Study characteristics
Methods RT
Setting: community participants
Follow up: 3 months
Participants 240 participants discharged to the community for the first time on oral anticoagulant warfarin (regardless of strength, gender, or age)
There was no significant difference between the groups in terms of age, all participants 60.2 years ± 17.84
Sex of participants: male 160 (58.3%). There was no statistically significant difference found between the groups based on indication for anticoagulation, with atrial fibrillation representing the most common indication. All participants lived close to the participating medical centre and could access it easily.
Country: United Arab Emirates
Comorbidity: atrial fibrillation: 82 (34.2%), valve replacement: 37(15.4%), CHF:32 (13.3%), peripheral artery disease: 8 (3.33%), left ventricular thrombus: 7 (2.91%), stroke: 9 (3.75%)
Interventions Intervention (Group A) was the 'counselled' group, whereas, control (Group B) was the 'non‐counselled' group.
After initial physician/pharmacist consultation in a standard care setting, 1 group was thoroughly counselled, defined by the following:
  • Once‐a‐week telephone consultation reviewing a series of pre‐designed set of questions (same questions asked weekly)

  • 2 home visits per month per participant by either a nurse or a pharmacist (reviewing questions and basic information). Visits were 12‐14 days apart, generally.

  • Any additional contact as requested by the participant in the intervention group.


The other group received no follow‐up consultation other than what was ordered by their own physician in a standard care setting. This group was asked only to visit the anticoagulation clinic twice a month for 3 months to evaluate international normalised ratio levels.
Outcomes Number of adverse events, emergency visits and inpatients admissions
Notes  
Risk of bias
Bias Authors' judgement Support for judgement
Random sequence generation (selection bias) Unclear risk Randomisation is not described
Allocation concealment (selection bias) Unclear risk The first 240 participants discharged or prescribed for the first time warfarin (regardless of strength, gender, or age) were divided randomly and assigned a intervention or control group.
Blinding of participants and personnel (performance bias)
All outcomes Unclear risk Not fully described: separation of intervention and control groups is not exclusive.
Incomplete outcome data (attrition bias)
All outcomes Low risk No loss of participants from the study
Blinding of outcome assessment (detection bias)
All outcomes Unclear risk Not described how and who measured the outcomes
Selective reporting (reporting bias) Low risk The study reported the proposed outcome.
Protection against contamination bias Unclear risk It is not clear if the control group was contaminated by the intervention.
Other bias Unclear risk Not applicable