Objective. Anticoagulation quality and record documentation were retrospectively assessed in patients with chronic nonvalvular atrial fibrillation (CNVAF) managed in a routine care setting. Methods. Medical record data extraction from physician practices in 4 regions of the United States. Results. Of 686 patients, 59% had an electrocardiogram confirming CNVAF, 84% listed at least 1 stroke risk factor, and 60% indicated the goal target international normalized ratio (INR). Two thirds of INRs >3.0 or <2.0 had no recorded dose change, nor did 45% of INRs >5.0. Vitamin K was given (3%) or anticoagulation was temporarily discontinued (9%) for INRs >5.0. The median interval of INR testing was 21 days, which decreased to 7 days for INRs > 4.60. Patients spent 58% of the time in therapeutic range. Conclusion. Serious deficiencies in quality and documentation of routine medical care of anticoagulation for patients with CNVAF continue to exist. (Am J Med Qual 2007;22:327-333)
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