Key result
INR self-testing with remote monitoring is preferred by ~90% of patients over clinic management.
Why the study?
The patient's perspective on international normalized ratio self-testing with online remote monitoring and management (STORM₂) for warfarin therapy had not been evaluated in the United States.
Does INR self-testing with online remote monitoring and management improve patient satisfaction, time, and cost compared to traditional clinic management in patients on long-term warfarin therapy?
Observational (n=43)
No
Does INR self-testing with online remote monitoring and management improve patient satisfaction, time, and cost compared to traditional clinic management in patients on long-term warfarin therapy?
INR self-testing with online remote monitoring and management is highly preferred by patients and reduces costs compared to traditional anticoagulation clinic management.
May support remote INR monitoring for satisfaction and cost savings; observational data leaves open need for randomized confirmation.
STUDY OBJECTIVE: International normalized ratio self-testing with online remote monitoring and management (STORM₂) is an alternative to anticoagulation clinic management, but the patient's perspective of this method has not been evaluated in the United States; thus we sought to evaluate the impact of STORM₂ on patient satisfaction, time, and cost. DESIGN: Prospective pre- and postintervention study. SETTING: Freestanding clinical research center. PATIENTS: Forty-three patients treated with long-term warfarin therapy and monitored initially in the anticoagulation clinic setting and then with STORM₂, referred from 11 medical practices. INTERVENTION: Patients were asked to complete a survey and the Duke Anticoagulation Satisfaction Scale (DASS) before (at baseline) and after at least 3 months of STORM₂ (at follow-up). MEASUREMENTS AND MAIN RESULTS: Patient satisfaction and time were assessed by survey and the DASS. Costs were measured from the patient's perspective. Overall 90% of responders preferred STORM₂ to traditional clinic management. The DASS questions indicated that patients were more satisfied with their anticoagulation treatment and more likely to recommend oral anticoagulation to a friend after experiencing STORM₂. In addition, patients found STORM₂ to be less complicated and more convenient than traditional clinic management. For each traditional monthly visit, patients drove 20 miles and expended a total of 1.8 hours; using 55¢/mile for mileage reimbursement and $15/hour for lost wages, the cost for each visit was $38. The total cost for four STORM₂ visits per month was $10, for a net savings of $28 per patient per month. A total of 76% of patients were willing to pay additional money to eliminate a monthly clinic visit. CONCLUSION: STORM₂ is more convenient, less complicated, preferred by patients, and saves patients time and money compared with clinic management.
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Meyer et al. (2013) conducted an observational in Long-term warfarin therapy (n=43). STORM₂ (INR self-testing with online remote monitoring and management) vs. Traditional anticoagulation clinic management was evaluated on Patient preference for STORM₂. INR self-testing with online remote monitoring (STORM₂) was preferred by 90% of patients over traditional clinic management and resulted in a net savings of $28 per patient per month.
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