INSTITUTING INR PATIENT-SELF TEST METERS IN ADULTS ON WARFARIN IN A CARDIOLOGY PRACTICE
Background: Warfarin is the oral anticoagulant that is most commonly used to control and prevent thromboembolic disorders. It is a sensitive medication that requires meticulous testing and dosing adjustments to attain therapeutic INR levels. An INR level is a crucial laboratory measurement to make certain the blood will not be too “thick” or “thin.” The goal of warfarin management is to administer the lowest possible dose to provide the patient protection against abnormal clotting conditions, therefore minimizing risk of bleeding or clotting. High rates of patients in non-therapeutic INR ranges are generally caused by failure of the provider to adjust INR doses based on monitoring. The PST meters offer a quick way to monitor therapeutic INR ranges in the convenience of the patients own home. Self-monitoring is associated with a reduced risk of all-cause mortality and lower rates of thromboembolism and bleeding. The purpose of this study was to evaluate the effectiveness of PST meters in adult patients diagnosed with atrial fibrillation, deep vein thrombosis, and mechanical heart valve on warfarin therapy in a Cardiology practice compared to traditional laboratory methods, or usual care.
Project Approach: Chart reviews were conducted to identify patients on warfarin in the practice with the medical indication of atrial fibrillation, deep vein thrombosis, and mechanical heart valve. Patients on warfarin therapy for greater than six months were included in this study. Data obtained from medical records included age, gender, medical indication, method of testing, and insurance carrier. Data will be analyzed over a four year time period (August 2010 – August 2014) for percent of time in therapeutic range. Data will be reported on the percentage of INR’s in therapeutic range for the practice setting based method of testing.
Outcomes: Data collection currently in progress
Conclusions: To be determined following review and analysis of results