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HSE to commence national survey of warfarin clinics

According to a HSE spokesperson, the number of individuals on warfarin therapy has fallen from around 35,000 in 2013 to 24,000 in 2016, with numbers continuing to reduce monthly.

“There are currently approximately 34,000 individuals on the more expensive newer oral anticoagulants and this number continues to increase (apixaban, dabigatran, edoxaban, rivaroxaban),” the spokesperson said.

A specialist advisory group has been established to commence work on the survey, MI understands.

Last year, the HSE Acute Hospitals Division discussed plans to close warfarin clinics, documents released by the HSE via Freedom of Information legislation show.

“National Director Acute Hospitals to set up a group comprising acutes, primary care to develop a proposal on what is the best way to manage this and the clinical appropriateness of the move to close warfarin clinics,” stated a document. 

A group was established to examine the issue, but the HSE said it does not have plans to close warfarin clinics and any decisions to do so have been taken locally.

HSE Clinical Lead for the National Stroke Programme and Consultant Stroke Physician Prof Joe Harbison told MI warfarin usage had dropped considerably and that most GPs were managing patients on warfarin, reducing the need for HSE clinics.

MI understands that just one warfarin clinic has closed in recent years — the Kilrush clinic in Co Clare, which ceased in 2015.

Another clinic — at St John’s Hospital, Limerick — reduced its service from three to two days per week in December 2016, a spokesperson for University of Limerick Hospitals said.

No warfarin clinics have closed within the South/South West Hospital Group (SSWHG) recently.

Mercy University Hospital in Cork runs three warfarin clinics weekly and average daily attendance is 50-to-60 patients, with the total number of patients on warfarin at 350, a SSWHG spokesperson stated.

Most warfarin clinics are hospital-based but community clinics are also operating.

In CHO 7, which covers Dublin South, Kildare and West Wicklow, warfarin community clinics have increased from five to six in recent years.

A warfarin clinic at South Tipperary General Hospital closed in 2008 and warfarin management for patients in the locality is managed by GPs.

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