Why the study?
Does home prothrombin time monitoring improve INR control in patients on oral anticoagulant therapy compared to standard management?
Does home prothrombin time monitoring improve INR control in patients on oral anticoagulant therapy compared to standard management?
Home PT monitoring is an effective alternative to specialized clinics for maintaining therapeutic INR levels in appropriately selected and trained patients on warfarin.
Supports home PT monitoring in trained patients; leaves open need for RCTs on clinical outcomes.
The anticoagulant activity of warfarin sodium is monitored by the prothrombin time (PT) using the international normalized ratio (INR). Standard oral anticoagulant therapy monitoring requires frequent patient visits to physicians' offices and/or laboratories to optimize warfarin dosage. Home PT monitoring by patients can increase testing frequency and may thus decrease complications associated with oral anticoagulant therapy. Clinical studies suggest that home PT monitoring is more effective than uncoordinated management and is as effective as care through specialized anticoagulation clinics for keeping INRs within a therapeutic range. There are accurate and reliable instruments available, but paramount to the success of home PT monitoring is sound patient selection, appropriate patient training, and consistent quality control.
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Robetorye et al. (2004) studied this question.
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