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Health practitioners in the primary care setting often assess and manage patients on warfarin therapy. This article discusses new trends in oral anticoagulation and the latest indications for warfarin use. Patient management and education guidelines to improve patient care and compliance with warfarin therapy are reviewed. Results of a 19-month evaluative, retrospective, descriptive study of a nurse practitioner-run clinic are summarized. The results support that anticoagulation clinics managed by nurse practitioners are safe and effective.