Factors influencing anticoagulation control of patients on warfarin therapy at Windhoek Central Hospital's Warfarin Clinic.

Thrombotic diseases are a global challenge. Warfarin remains the anticoagulant of choice in low- and middle-income countries. In 2017, a study reported suboptimal anticoagulation control of 29.4%, compared to the target of ≥ 65%, in patients who attended the Windhoek Central Hospital's warfarin clinic.Factors contributing to the suboptimal anticoagulation control had to be explored.To achieve this, 72 patients from the interventional cohort at the clinic were interviewed.The majority (39%) of respondents had dosage-related factors, followed by 21% with diet-related factors, 19% reported factors associated with social determinants of health, and the least (5.6%) due to drug interactions in patients with a co-diagnosis of tuberculosis.The study highlighted the need for improved healthcare system support, such as equipping non-physician health cadres (pharmacists and nurses) with the ability to prescribe warfarin therapy and roll out point-of-care testing for patients with limited access to primary healthcare settings, improving access to medication at the primary healthcare facilities, and patient education to improve warfarin therapy outcomes.