Resources from NBCA’s Clinical Pearls Series

Webinar: Overcoming the Headache of Fluctuating INRs

  • Have you lived the headache of watching patient’s INRs fluctuate?
  • How often do you encounter a patient whose INR is difficult to control?
  • How aware are you of factors that cause INRs to go up and down?
  • How skilled are you at working with a patient to factor his or her “real life” challenges into a useful and workable anticoagulation plan?

Recorded Webinar:

Click here to view the recorded webinar using Windows Media Player.

About the Webinar

National Blood Clot Alliance (NBCA) is presenting this webinar for nurses, nurse practitioners, pharmacists, and physician assistants to address these questions with specific tips and a representative case study.

This is the second in the Clinical Pearls webinar series developed by NBCA to address topics related to care of patients with blood clots, with an emphasis on providing strategies to improve patient adherence.

Through an effective and easy-to-understand “5A” framework for catalyzing patient behavior change, you can learn tactics to create an alliance of trust to move a patient through the everyday challenges of staying adherent while on anticoagulant therapy.  The 5A actions include assess, advise, agree, assist, and arrange.

This webinar is supported by Cooperative Agreement 5U27 DD00545-01 from the Centers for Disease Control and Prevention.

Web Resources:

For a patient video on Coumadin® (warfarin) from the manufacturer:


For patient information on Lovenox®, a low molecular weight heparin, from the manufacturer:


For patient information on Arixtra® (fondaparinux sodium) from the manufacturer:


Additional References

  • Atreja A, Bellam N., Levy, S.   Strategies to Enhance Patient Adherence:  Making it Simple.  MedGenMed 2005; 7(1) 4.  Published online 2005 March 15.  Medscape General Medicine.
  • Wofford, James L et al. Best strategies for patient education about anticoagulation with warfarin: a systematic review BMC Health Services Research 2008, 8:40.
  • Schillinger, Dean et al.  Language, Literacy, and Communication Regarding Medication in an Anticoagulation Clinic: A Comparison of Verbal vs. Visual Assessment.  Journal of Health Communication, 11:651-664, 2006.

Note: National Blood Clot Alliance does not endorse any products or manufacturers, including those referenced in these resources.

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