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| Impact of Food Insecurity on Anticoagulation Quality Among Patients receiving Warfarin at a Safety Net Academic Center. |
| Yva Gauthier2, Alyssa E. Utz2, Mikhail Y. Akbashev2,3, Kapil Chandora1,2, Feyi M. Ward1,2 1Morehouse School of Medicine, Atlanta, GA, United States/2Grady Health System, Atlanta, GA, United States/3Emory University School of Medicine, Atlanta, GA, United States |
Introduction Warfarin management remains essential for a variety of anticoagulated patients and is impacted by dietary vitamin K intake, potentially leading to variation in international normalized ratio (INR), and increased bleeding or thrombosis. Food insecurity (FI) may limit consistent access to vitamin K foods, and thus INR control. This cross-sectional cohort study aims to characterize the correlation of FI and time in therapeutic range (TTR). Methods This IRB approved retrospective cohort study reviewed patients who screened positive on a social determinant of health questionnaire and had warfarin dosing managed at the institution’s anticoagulation clinic between September 2023 and 2024. Data was obtained from the electronic health record and analyzed using qualitative methods. Patients 18 years or older who had three or more INR results during the study period were included. Results Of 38 patients included, majority were African Americans. Anticoagulation indication included 18 valve, 12 venous thromboembolism, four atrial fibrillation, and four others. There were 27 patients with moderate FI and 11 with severe FI. TTR for patients with moderate FI was 56.31% and 43.09% for severe FI (p = 0.13). Last outpatient INR at goal range for patients with moderate FI was 48% and 18% for severe FI (p = 0.067). Conclusion Although it did not meet pre-defined statistical thresholds, worsening FI was associated with worsening INR control. Small sample size was a limitation. Screening for and addressing FI may impact quality of warfarin care. |