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Warfarin Quality Metrics (NPSA Audit) Report

Contains many of the statistics specified by the NPSA Safety Alert, which typcially locations are required to provide as part of their audit.

This report calculates the following NPSA statistics over a specified date range, filtered by location:-
•Percentage of Patients developing an INR > 5
•Percentage of INR readings > 5
•Percentage of INR readings > 8
•Percentage of INR readings > 1 below target
•Percentage of Patients with Major Bleed in 1st month
•Percentage of Patients with a Major Bleed in 1st month & an INR above Target INR
•Percentage of Patients with an unknown target INR
•Percentage of Patients with an unknown diagnosis
•Percentage of Patients with an unknown stop date
•Percentage of Adverse Outcomes Categorised by Type
•All-time TTR and 12 month TTR for the specified location


Use this report to:

  • complete audit forms sent out by your CCG

Please look under 'Additional files' on the right-hand side of this page to view or download an example report

We currently calculate TTR using the Rosendaal method (ie total days in range/total days on treatment) for individual patients and separately for the whole location.

We exclude any treatments which are flagged as ‘induction’ and we also exclude any treatments within the first 2 weeks of a patient’s start date.

We did a study to see what the difference in total TTR would be if we excluded treatments from the first 1, 2, 4 and 6 weeks and there was actually very little so we currently stick to 2 weeks. The new NICE guidelines in AF suggest excluding the first 6 weeks so we will be rewriting the TTR reports to take this into account soon – but there will be very little difference in the outcomes(The TTR results will be slightly higher). 

We currently include all patients in TTR calculations but the new NICE AF guidelines suggest only including patients who have at least 6 months of results. This will also tend to push the TTR figures up.

The ‘Warfarin Quality Metrics (NPSA Audit)’ report shows the TOTAL calculated TTR for all  patients at a location for the preceding 12 months. 

The ‘Patient TTR band’ report displays the frequency distribution of the TTR results of INDIVIDUAL patient TTRs at a location for the last 12 months

These graphs  are not directly comparable.

Category: Clinical Audit