Liverpool-based nurses have recently embarked on a visit to Cape Town, South Africa and Kampala, Uganda, as part of the NIHR-funded Global Health Research Group to share best practice in anticoagulation research and patient management.
Led by Professor Munir Pirmohamed at the Wolfson Centre for Personalised Medicine, based in the University’s Institute of Translational Medicine, the ‘Warfarin anticoagulation in patients with cardiovascular disease in Sub-Saharan Africa’, is a three-year research collaboration between the University of Liverpool, Infectious Diseases Institute, Makerere University, Uganda and University of Cape Town, South Africa.
The study focuses on a clinically important non-communicable disease area which requires the use of anticoagulants which are medicines that help prevent blood clots.
Anticoagulation represents an unmet clinical need in Sub-Saharan Africa as patients either do not receive anticoagulation (because of difficulties in monitoring) or are inadequately anticoagulated because of poor dosing guidelines.
In addition, the anticoagulant 1mg warfarin is currently not available in either country which makes dose titration, the process of adjusting the dose of a medication for the maximum benefit without adverse effects, challenging.
The study aims to improve anticoagulation by developing clinical dosing algorithms, and further improve anticoagulation quality by using novel technological advances.
The research is accompanied by education and training of the local workforce to improve capability and capacity, which includes nurses from the UK visiting Africa to share best practice in anticoagulation research and patient management.
Clare Prince, Research Nurse at the Wolfson Centre for Personalised Medicine (WCPM) and Samantha Riccio, Clinical Nurse Specialist, Roald Dahl Centre at The Royal Liverpool and Broadgreen University Hospitals, visited Africa to share their expertise to local nurses and doctors. The visit addressed gaps in the understanding of prescribing anticoagulation and misconceptions held by healthcare providers locally.
Clare provided insight in to research and implementation projects relating to warfarin and genetic guided dosing as well as providing a broad overview of the other projects at WCPM. Meanwhile, Samantha discussed dosing regimens used in the Liverpool Anticoagulation Service, advice given to patients, and managing unstable/complex patients.
Samantha and Clare discussing anticoagulation with doctors and nurses in Kampala with Ugandan co-Investigator Dr Christine Sekaggya
Training sessions were made open to clinical staff in the local communities as part of their continuing medical education; allowing the project to reach a greater audience in the LMIC (Low and Middle Income Countries) setting. Further visits from UK nurses will take place in 2019 and 2020.
For more information on the study please visit www.warpath.info or updates can be found on the Twitter account @WarPATH_GHR
The research was commissioned by the National Institute for Health Research using Official Development Assistance (ODA) funding.