Optimisation of warfarin therapy can be achieved through structured International Normalised Ratio (INR) monitoring. Healthcare professionals and patients can reduce adverse events, including stroke, by routine control of their INR. Time in therapeutic range (TTR) of 65 per cent or more is easily achievable through either near-patient or patient self-monitoring, as detailed below.
Near Patient Testing
Implementing a Near Patient Testing (NPT) service has been encouraged by a National Enhanced Service (NES) scheme, introduced in 2003/4. The aim of the scheme is to operate warfarin clinics in primary care and pharmacy settings, thereby reducing the burden on hospital clinic waiting times and providing a more cost-effective and convenient service for patients in their local health communities.
A CoaguChek XS Plus monitoring service has been established in more than 350 sites across the UK, which in conjunction with dosing software, can deliver an optimised and fully auditable INR service.
Visit the links below to see guidance and evaluations on the CoaguChek XS Plus monitor.
Setting the Standards in Anticoagulation Service Delivery
Evaluation Report – CoaguChek XS
External Quality Assement – CoaguChek XS
Patient self-care is becoming more and more popular for INR testing, and with positive messages around patient choice and empowerment from the department of health is easy to understand why.
There are essentially two approaches to self-monitoring:
Patient self-testing - the patient takes their own INR reading by a finger prick of blood applied to a test strip and then informs the relevant healthcare professional.
Patient self-management – In agreement with their healthcare professional, the patient amends their own warfarin dose. This can avoid the need to make regular visits to see their healthcare professional.
The CoaguChek XS monitor is easily portable and the test takes about two minutes. Extensive clinical trials have demonstrated significant benefits for patients.