Point-of-care INR coagulometers for self-management of oral anticoagulation: primary care diagnostic technology update

Q: What is the clinical evidence from this study?

Study design: Review. Population: Long-term oral anticoagulation therapy. Intervention: Self-management and self-monitoring of INR using point-of-care coagulometers vs. Standard clinic-based care. Primary outcome: Thromboembolic events (HR 0.51, 95% CI 0.31 to 0.85).

Annette Plüddemann; Matthew Thompson; Jane Wolstenholme; Christopher P. Price; Carl Heneghan

doi:10.3399/bjgp12x658476

October 30, 2012British Journal of General PracticeOpen Access

Point-of-care INR coagulometers for self-management of oral anticoagulation: primary care diagnostic technology update

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Why the study?

Does self-management using a home monitoring device for INR improve outcomes and accuracy in patients who require long-term anticoagulation treatment compared to standard practice?

Structured PICO

Does self-management using a home monitoring device for INR improve outcomes and accuracy in patients who require long-term anticoagulation treatment compared to standard practice?

P

Population

Patients requiring long-term oral anticoagulation therapy for conditions such as atrial fibrillation, venous thromboembolism, or prosthetic heart valves.

I

Intervention

Self-management (self-testing and self-adjusting) or self-monitoring (self-testing and adjustment by clinician) of oral anticoagulation using point-of-care INR coagulometers (e.g., CoaguChek XS, INRatio, ProTime).

C

Comparator

Standard practice / conventional clinic-based anticoagulation care.

O

Outcome

Thromboembolic events, major haemorrhage, all-cause mortality, and INR accuracy.hard clinical

Main Result

Hazard Ratio: 0.51 (95% CI 0.31–0.85)

Limitations

Translation of evidence into primary care settings is limited.
Patient self-management may be more expensive than available routine care in some economic models.
Patient level data was not available for some of the cited cost-effectiveness reviews.
Translation of evidence into primary care settings is limited

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Implication

Point-of-care INR self-management is as accurate as laboratory testing and significantly reduces thromboembolic events and mortality compared to standard clinic-based care.

Abstract

In patients who require long-term anticoagulation treatment, how accurate and effective is self-management using a home monitoring device for INR, compared to standard practice?

Discussion

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Cite This Study

Plüddemann et al. (2012) conducted a review in Long-term oral anticoagulation therapy. Self-management and self-monitoring of INR using point-of-care coagulometers vs. Standard clinic-based care was evaluated on Thromboembolic events (HR 0.51, 95% CI 0.31 to 0.85).

synapsesocial.com/papers/6a82d7c20715daaa1f23c12f https://doi.org/10.3399/bjgp12x658476

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Point-of-care INR coagulometers for self-management of oral anticoagulation: primary care diagnostic technology update

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Point-of-care INR coagulometers for self-management of oral anticoagulation: primary care diagnostic technology update

Structured PICO

Main Result

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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