A growing body of evidence suggests that adequately trained patients can safely monitor their own anticoagulation. The studies that were conducted have resulted in positive clinical outcomes and fewer complications of therapy when compared to usual care.
Home international normalized ratio (INR) testing devices were approved by the FDA in 1997. Insurance companies are beginning to cover the devices, the costs of which range from $1300 to $2500. Test strips are an additional $6 to $10 each. The advantages of home testing include flexibility and satisfaction, improved safety, and timely treatment. Limitations include the need for quality-control checks, and procedures that must be followed exactly to avoid erroneous results.
Not everyone is a good candidate for home testing. In order to achieve good outcomes, the patient must have a moderate degree of manual dexterity, good vision, and the ability to interpret information and follow a dosing nomogram. For patients who are able to meet these requirements, home testing may offer a safe, convenient alternative to traditional monitoring.
Dr. Garrett is a clinical pharmacist practitioner at Cornerstone Health Care in High Point, NC.
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