Effect of distance to health facility on the maintenance of INR therapeutic ranges in rheumatic heart disease patients from Cape Town: no evidence for an association

摘要: Lack of adherence to international normalised ratio (INR) monitoring in rheumatic heart disease (RHD) patients is a contributor cardio-embolic complications. This population-based observational study investigated whether the distance between home and an INR clinic affects maintenance therapeutic RHD on warfarin. Residential addresses, clinics, results with were extracted from Cape Town component Global Rheumatic Heart Disease Registry (REMEDY) database. Addresses homes clinics converted geographical coordinates verified ArcGIS 10®. 10® Google Maps® used for spatial mapping obtaining shortest road distances respectively. The travel was correlated time within range (TTR) using Rosendaal linear interpolation method, fraction range, based average three readings compared recommended ranges. (n = 133) resided 0.2 km 50.8 km (median distance, 3.60 km) one 33 clinics. There no significant difference achievement who travelled shorter those longer (in range = 3.50 km versus out range = 3.75 km, p = 0.78). finding same mechanical valve replacement (n = 105) (3.50 km 3.90 km, p = 0.81), native valves (3.45 km 2.75 km, p = 0.84). association amongst patients’ residence clinic.