EFFECTIVENESS OF INR PATIENT SELF-TESTING IN ADULTS ON WARFARIN IN PRIMARY CARE
IN ADULTS ON WARFARIN IN PRIMARY CARE
PURPOSE:
To compare the clinical effectiveness of INR patient self-testing in adults on warfarin therapy versus usual care in a primary care setting.
BACKGROUND:
Warfarin is the most commonly prescribed oral anticoagulant for the prevention and treatment of venous thromboembolism. Due to its narrow therapeutic index, warfarin requires close monitoring of the international normalized ratio (INR) to ensure proper anticoagulation control and safety. INRs outside of this range are strongly associated with an increased risk of major bleeding, thromboembolic events and even death. Patient self-testing (PST) using a point-of-care device allows patients to monitor their INR results from home. Evidence shows that PST improves the clinical outcomes of warfarin therapy compared to usual care, which includes laboratory INR monitoring.
METHODS:
Patient data including age, gender, insurance provider, INR results and method of INR testing, were retrieved from electronic medical records, contracted laboratories, and the PST vendor website from January 2010 to September 2014. Eligible patients, adults on warfarin therapy for more than 6 months, were offered to participate in PST using a point-of-care device to monitor their INR levels at home. The Nurse Practitioner of the primary care setting provided meter set-up and hands-on training to participants individually. Participants monitored their INR at least twice a month and the results were communicated to the providers through a secure website. The percentage of time spent within therapeutic INR range (TTR) using PST was calculated and compared to the TTR for usual care.
OUTCOMES:
Pending.
CONCLUSIONS:
Pending.