Virtual education for warfarin patient self-testing significantly increased time in therapeutic range by an absolute difference of 2.59% compared to traditional in-person training.
Observational (n=33,683)
Does virtual training for warfarin patient self-testing maintain or improve time in therapeutic range compared to in-person training in warfarin users?
Virtual education for warfarin patient self-testing is effective and results in slightly higher time in therapeutic range compared to traditional in-person training.
Effect estimate: Absolute difference 2.59 (95% CI 2.50-2.68)
Absolute Event Rate: 66.78% vs 64.19%
p-value: p=<0.001
BACKGROUND: Prior to the COVID-19 pandemic, warfarin users were required to complete in-person training in order to participate in approved international normalized ratio (INR) patient self-testing (PST) programs. To minimize in-person contact during the pandemic, a federal waiver of the in-person training requirement allowed new patients to begin PST after completing virtual training. However, it was uncertain whether such patients achieved comparable levels of INR control to patients receiving in-person training. METHODS: INR results for patients receiving virtual training upon PST commencement between April 1, 2020, and December 31, 2020, were compared to those of patients initiating PST with in-person training between April 1, 2019, and December 31, 2019. The primary outcome was the difference in warfarin time in therapeutic range (TTR) between the groups, with secondary outcomes including differences in the percentages of INR values within individually prescribed INR range and of critical INR values. RESULTS: The records of 33,683 patients were included in the analysis (13,568 in the "In-Person" sample; 20,115 in the "Virtual" sample). Patients in the Virtual sample achieved a TTR of 66.78%, compared to the In-Person sample (64.19%; absolute difference 2.59; 95% confidence interval CI = 2.50-2.68, p < 0.001). The TTR values were also statistically significantly higher in all subgroups evaluated across categories of patient age, gender, geography, and indication. Similarly favorable results were achieved for INR values in range and critical values. CONCLUSION: Virtual education for PST for warfarin therapy is effective and should continue to be an option for patients and providers throughout the pandemic, and possibly beyond.
Price et al. (Mon,) conducted a observational in Warfarin therapy (n=33,683). Virtual training for patient self-testing (PST) vs. In-person training for PST was evaluated on Warfarin time in therapeutic range (TTR) (Absolute difference 2.59, 95% CI 2.50-2.68, p=<0.001). Virtual education for warfarin patient self-testing significantly increased time in therapeutic range by an absolute difference of 2.59% compared to traditional in-person training.