Weekly dosing regimens are helpful for patients who will continue anticoagulation therapy after discharge, especially those patients who may require long-term therapy. For patients who will have post-discharge anticoagulation needs, begin a weekly dosing regimen with the initial medication order in the hospital. This allows these patients to practice administering their own medications under the supervision of medical staff before they are discharged from the hospital. When anticoagulant doses are prescribed for administration every other day, the weekly dosing regimen helps staff members and patients keep track of the total weekly amount administered. Tracking both the individual doses and the total weekly dose provides a double-check that the proper dose is being administered.
- Encourage patients to manage their own therapy by instituting patient-directed warfarin dosing.
- Avoid giving initial large, loading doses. Onset of antithrombotic action does not happen any sooner, and this approach may be especially hazardous for patients at risk of hemorrhage or necrosis.
- Develop a dosing service or clinic to assist outpatients with warfarin management.
- Use weekly dosing regimens as a way to educate patients about their therapy.
- Include patients in the education process as well as family members, other people who live with the patients, or friends or professionals that assist with their care.