Key result
A survey of representatives from 14 countries found that INR monitoring is predominantly managed by general practitioners, with patient self-monitoring occurring in only a few countries.
Cross-Sectional (n=14)
Yes
INR monitoring is primarily managed by general practitioners across 14 surveyed countries, highlighting the role of primary care consultations in comprehensive patient management.
May inform adaptation of anticoagulation services; leaves open optimal INR strategies in mixed VKA-NOAC populations.
Background: New oral anticoagulants (NOACs) are predicted to become the new standard treatment for stroke prevention in patients with atrial fibrillation, and may replace vitamin K antagonists (VKAs). NOACs are prescribed less than expected, even though they do not require international normalised ratio (INR) monitoring. In this study we assessed methods for INR monitoring after the introduction of NOACs a in heterogeneous sample of countries. Methods: We asked representatives of the Vasco da Gama Movement, a network of junior and future gen- eral practitioners (GPs) in Europe, and WONCA, the World Organization of Family Doctors, to describe the way INR is monitored in their respective countries. Results: Representatives of 14 countries responded. In most countries, the INR is monitored by GPs; in some countries, these patients are treated by other specialists or in specialised anticoagulation centres. In only a few countries, anticoagulated patients monitor the INR themselves. Conclusion: Our study showed several strategies for managing anticoagulation in different countries. In most countries, the INR is monitored by GPs. These consultations offer opportunities to address other is- sues, such as blood pressure control or medication adherence. These factors may be considered when de- ciding to switch patients from VKAs to NOACs.
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Streit et al. (2013) conducted a cross-sectional in Atrial fibrillation requiring anticoagulation (n=14). INR monitoring strategies was evaluated on Methods for INR monitoring. A survey of representatives from 14 countries found that INR monitoring is predominantly managed by general practitioners, with patient self-monitoring occurring in only a few countries.
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