Anticoagulation is one of the highest-risk areas of outpatient medicine. Clinit tracks INR trends, TTR, DOAC adherence, and bleeding/clotting events in one structured workflow.
The Anticoagulation Challenge
Anticoagulation management sits at the intersection of efficacy and safety in a way few other drug classes do. For warfarin patients, the therapeutic window is narrow (INR 2.0–3.0 for AF, 2.5–3.5 for mechanical valves), the interactions are numerous, and the consequences of being out of range — stroke or major bleed — are catastrophic.
Warfarin Tracking in Clinit
INR Log:
Each INR result is entered with the date, value, and the anticoagulation clinic or lab that performed the test. Clinit plots a longitudinal INR chart with the therapeutic range displayed as a shaded band. Values outside range are highlighted in amber (sub-therapeutic) or red (supra-therapeutic).
Time in Therapeutic Range (TTR):
Clinit automatically calculates TTR using the Rosendaal linear interpolation method — the same method used in the major AF trial analyses. A TTR below 65% triggers a recommendation to consider DOAC switch.
Dose Adjustment:
When an INR is out of range, the clinician can record the dose adjustment and the next INR due date. The system generates a WhatsApp reminder for the patient on the due date.
Interaction Alerts:
When a new drug is prescribed for a warfarin patient, the interaction checker flags drugs with known INR-altering effects (antibiotics, NSAIDs, antifungals, amiodarone) and suggests more frequent INR monitoring.
DOAC Adherence Tracking
For patients on apixaban, rivaroxaban, dabigatran, or edoxaban:
- Dose, frequency, and indication are recorded
- Adherence is reviewed at each visit using the Morisky-8 scale (quick-select chips in the session tab)
- Renal function (eGFR) is displayed alongside DOAC prescription — DOACs are contraindicated at eGFR <15 and require dose reduction at lower eGFR thresholds
Bleeding and Clotting Events
All events — major bleed, clinically relevant non-major bleed, TIA, stroke, systemic embolism — are recorded in a structured events log with date, severity, hospitalisation, and management. The events are visible in the cardiology session header and in referral letters.
