An evaluation of near‐patient testing of anticoagulant control in general practice

PURPOSE: This paper aims to compare anticoagulant management in secondary care for the year prior to the introduction of near-patient testing in a general practice, and in the subsequent year after it was introduced. DESIGN/METHODOLOGY/APPROACH: This paper is a retrospective, paired before-after study. Details of test results in the two-year-long periods on the 46 patients who met the inclusion criteria were collected and analysed pairwise. FINDINGS: Despite an increase in the frequency of testing this set of patients were controlled as well in general practice as they had been with a secondary-care service, and better that in a number of studies in the literature. RESEARCH LIMITATIONS/IMPLICATIONS: This research reviews a recently introduced service at a single centre. Further research of patient satisfaction and adverse events in a multi-centre longer-term trial are desirable. PRACTICAL IMPLICATIONS: Technology now allows the increasing amount of individuals on anticoagualtion to be controlled with near-patient testing in general practice. This study shows that satisfactory control can be maintained in patients who transfer from a secondary care-based to a primary care-based service. ORIGINALITY/VALUE: This paper demonstrates that a single general practice can provide a high quality anticoagulant service using near-patient testing and computer-based decision support. This adds to the already available evidence and will hopefully encourage other practices to adopt the same.