scholarly journals Validation of the international normalized ratio (INR) in a new point-of-care system designed for home monitoring of oral anticoagulation therapy

2009 ◽  
Vol 31 (1) ◽  
pp. 20-25 ◽  
Author(s):  
W. PLESCH ◽  
A. M. H. P. Van Den BESSELAAR
Keyword(s):  
Oral Anticoagulation ◽  
Point Of Care ◽  
Anticoagulation Therapy ◽  
Home Monitoring ◽  
International Normalized Ratio ◽  
Oral Anticoagulation Therapy ◽  
Point Of Care System ◽  
Care System

Implementation of SintromacWeb®, a new internet-based tool for oral anticoagulation therapy telecontrol: Study on system consistency and patient satisfaction

2010 ◽  
Vol 103 (05) ◽  
pp. 1091-1101 ◽  
Author(s):  
Yolanda Mira ◽  
María Teresa Contreras ◽  
Cristina Aguado ◽  
José Antonio Aznar ◽  
Fernando Ferrando
Keyword(s):  
Patient Satisfaction ◽  
Oral Anticoagulation ◽  
Point Of Care ◽  
Anticoagulation Therapy ◽  
International Normalized Ratio ◽  
Final Visit ◽  
Normal Range ◽  
Oral Anticoagulation Therapy ◽  
Self Testing ◽  
Anticoagulated Patients

SummaryMost computer- or internet-assisted systems for oral anticoagulation therapy (OAT) telemanagement have limitations when it comes to implementation within a healthcare center. It was the objective of this study to evaluate convenience and patient satisfaction with the use of SintromacWeb→, a new OAT telecontrol system, compared with the conventional control. SintromacWeb® consists of a point-of-care device for patient international normalized ratio (INR) self-testing and software that allows internet mediated interaction with physicians. Patients initiated the use of SintromacWeb→ and were followed up during a three-month period. A score-based questionnaire was completed in three controlled visits, and data were subsequently analysed. A total of 102 patients were enrolled. At first visit, 55.7% of the patients had their INR within normal range, and 64.9% at the final visit. Internal consistency of the questionnaire was good (Cronbach‘s α: 0.79). Scores in the questionnaire were independent of patient’s age, education level, working status and INR value. The most valued features of SintromacWeb® were: fewer visits to the hospital, simplicity and convenience of the system, and time administration for control tasks (86.7%, 82.7% and 77.6% of very satisfied patients, respectively). Also, patients showed indifference or were dissatisfied with the conventional system. At the final visit, 99% of patients declared that they were satisfied with their OAT control. Moreover, all patients continued using Sintrom -acWeb→ after completion of the study. In conclusion, SintromacWeb→ telecontrol is a new model for management of anticoagulated patients. It was highly accepted and can be used by all patients regardless of their sociodemographic characteristics.

Accuracy of point of care coagulometers compared to reference laboratory measurements in patients on oral anticoagulation therapy

2016 ◽  
Vol 140 ◽  
pp. 66-72 ◽  
Author(s):  
Jean-Guillaume Dillinger ◽  
Thiziri Si Moussi ◽  
Natacha Berge ◽  
Claire Bal Dit Sollier ◽  
Patrick Henry ◽  
...  
Keyword(s):  
Oral Anticoagulation ◽  
Point Of Care ◽  
Anticoagulation Therapy ◽  
Reference Laboratory ◽  
Laboratory Measurements ◽  
Oral Anticoagulation Therapy

scholarly journals IMPACT OF PHARMACIST LED ANTICOAGULATION MONITORING AND PATIENT EDUCATION ON ORAL ANTICOAGULATION THERAPY WITH ACENOCOUMAROL

2017 ◽  
Vol 10 (10) ◽  
pp. 314
Author(s):  
Poojitha Reddy Reddy ◽  
Omsri Mounika ◽  
Gaddam Chandrika ◽  
Aldrich Franklin ◽  
Ramesh M ◽  
...  
Keyword(s):  
Patient Education ◽  
Drug Interactions ◽  
Oral Anticoagulation ◽  
Anticoagulation Therapy ◽  
Therapeutic Index ◽  
International Normalized Ratio ◽  
Rank Test ◽  
Oral Anticoagulation Therapy ◽  
Before And After ◽  
The Impact

  Objective: Acenocoumarol is anoral anticoagulant with narrow therapeutic index, and the ideal dose of anticoagulation lies between International normalized ratio (INR) values of 2.0 and 3.5. Lack of monitoring and knowledge on acenocoumarol therapy may compromise patient’s safety resulting in under- or over-anticoagulation. A study was conducted to monitor for the safety of anticoagulation therapy, achievement of goal INR levels and to assess the impact of pharmacist led anticoagulation monitoring and patient education on the rational use of acenocoumarol in patients admitted in cardiology wards with thromboembolic disorders.Methods: The study was conducted in 70 patients; data collection was done, prescriptions were analyzed for drug-drug interactions and adverse drug reactions (ADRs). Patients’ knowledge on acenocoumarol therapy was assessed using a self-developed questionnaire at the baseline, then were subjected to a detailed patient education and on an average each patient received three sessions of education. They were again made to answer the same questionnaire on the day of discharge. The mean score of the responses before and after education was compared statistically using Wilcoxon signed rank test and McNemar test.Results: There were 60% patients under anticoagulated with the INR range of >2.0. 123 drug interactions were observed in 58 patients, on an average of 2 interactions per prescription, but no ADRs were observed. 59 patients (84.3%) showed significant overall improvement in knowledge on anticoagulation therapy following education.Conclusion: This study implies the role of clinical pharmacists in achieving better clinical outcomes in patients receiving oral anticoagulation therapy with acenocoumarol.

scholarly journals Poor Agreement among Prothrombin Time International Normalized Ratio Methods: Comparison of Seven Commercial Reagents

2005 ◽  
Vol 51 (3) ◽  
pp. 553-560 ◽  
Author(s):  
Juha Horsti ◽  
Helena Uppa ◽  
Juhani A Vilpo
Keyword(s):  
Clinical Practice ◽  
Patient Care ◽  
Prothrombin Time ◽  
Oral Anticoagulation ◽  
Anticoagulation Therapy ◽  
International Normalized Ratio ◽  
Poor Agreement ◽  
Oral Anticoagulation Therapy ◽  
The Mean ◽  
The Difference

Abstract Background: Prothrombin time (PT) has long been the most popular test for monitoring oral anticoagulation therapy. The International Normalized Ratio (INR) was introduced to overcome the problem of marked variation in PT results among laboratories and the various recommendations for patient care. According to this principle, all reagents should be calibrated to give identical results and the same patient care globally. This is necessary for monitoring of single patients and for application of the results of anticoagulation trials and guidelines to clinical practice. Methods: We took blood samples from 150 patients for whom oral anticoagulation had been prescribed. Plasmas were separated and PTs determined by use of seven commercial reagents and four calibrator sets. The differences in results were assessed by plotting, for each possible pair of methods, the differences in INR values for each sample against the mean INR value (Bland-Altman difference plots). Results: Mean results differed significantly (P <0.001) for 17 of 21 possible paired comparisons of methods. Only two pairs of methods produced very similar results when assessed for problems of substantial differences in INR values; a significant, systematic increase in the difference with INR; and a significant systematic increase in the variation in difference with increasing INR values. Conclusions: The agreement among several (and perhaps most) commercial INR methods is poor. The failure of current calibration strategies may severely compromise both the monitoring of individual patients and the application of oral anticoagulation guidelines and trial results to clinical practice.

Sign in / Sign up

Export Citation Format

Share Document