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.

A Multi-Instrument Evaluation of a Commercial Chromogenic Factor X Assay To Monitor Oral Anticoagulation Therapy.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 4059-4059 ◽  
Author(s):  
David L. McGlasson ◽  
Patrick N. Shaklee
Keyword(s):  
Oral Anticoagulation ◽  
Anticoagulation Therapy ◽  
Normal Subjects ◽  
Factor X ◽  
Normal Range ◽  
Precision Data ◽  
Oral Anticoagulation Therapy ◽  
Instrument Evaluation ◽  
Correlation Range ◽  
Precision Testing

Abstract Introduction: A multi-instrument evaluation of the chromogenic DiaPharma Factor X Assay kit (DFX) was undertaken in order to evaluate the utility of the kit for measuring factor X levels in patients receiving oral anticoagulation therapy (OAT). Methods: The DFX microtiter method was compared to a clottable FX (CFX)method in Laboratory 1. All clottable assays were performed on the Diagnostica-Stago STA automated coagulation analyzer using STA Neoplastine CI+ as the thromboplastin reagent with a low ISI. All testing was performed on citrated plasmas. A normal range was established using 30 normal subjects. Clinical sensitivity was tested using 30 specimens from subjects on OAT. The samples were assayed for FX levels by DFX and CFX, and international normalized ratios (INR) were calculated. Thirty-one specimens that were positive for the presence of hemolysis, icteric color, lipemia, heparin and lupus anticoagulants (LA) were analyzed for FX by both methods to check for the influence of interfering substances. Nineteen subjects with the presence of an LA on OAT and an unstable INR with specimens taken at 8 time points were evaluated by both methods. Laboratory 2 used an STA compact and reagents to evaluate both the CFX and DFX methods. A normal range was established using 25 normal subjects on both methods. Fifty-five subjects on OAT were evaluated by both the CFX and the DFX methods. Precision and accuracy testing using different levels of FX were analyzed by all methods at both institutions. Results: The results of both laboratories are as follows: FX Chromogenic vs. Clotting Precision Data: Laboratory 1 performed precision testing using times 10 replicates on 6 specimens, run on the DFX in the range of 10 – 120% FX activity. Using 5 known standards for the DFX, assay accuracy ranged from 99.2 – 100.8% recovery. Laboratory 2 performed precision testing on 3 levels of FX (n = 12). Precision Data Conclusions: The present studies of the DFX kit demonstrated the assays robustness, precision, accuracy and utility for monitoring patients on OAT with and without interfering substances, the presence of an LA or unstable INR. The DiaPharma Factor X Kit recently received 510(k) market clearance from the FDA. This assay should offer health care providers an option for monitoring patients receiving OAT, especially those where INR values may not be reliable when an LA is present, and screening for factor X deficiencies. Laboratory 1 Normals (n=30) OAT (n=30, INR=1.74-5.9) Range Mean Correlation Range Mean Correlation Chromogenic 72.0 – 137.6% 113.8% 0.906 19.3 – 62.5% 31.0% 0.903 Clotting 94.1 – 159.7% 109.5% 7.0 – 48.0% 13.9% OAT with presence of LA (n = 19) Interfering Substances (n=31, INR 1.0 – 1.2) Range Mean Correlation Range Mean Correlation Chromogenic 7.0 – 122.0% 33.1% 0.841 101.2 – 126.4% 113.8% 0.906 Clotting 2.7 – 101.0% 22.8% 97.4 – 120.7% 109.5% Laboratory 2 Normals (n = 25) OAT (n=55) Range Mean Correlation Range Mean Correlation Chromogenic 83.0 – 147.0% 120.4% 0.871 17.0 – 65.0% 32.5% 0.948 Clotting 69.0 – 139.0% 105.7% 2.0 – 41.0% CV (%) Laboratory 1 Laboratory 2 Chromogenic 1.9 – 10.4% 2.5 – 5.1% Clotting N/A 4.6 – 9.2%

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

Technology-assisted self-testing and management of oral anticoagulation therapy: a qualitative patient-focused study

2016 ◽  
Vol 31 (3) ◽  
pp. 603-617 ◽  
Author(s):  
Jasna Kuljis ◽  
Arthur G. Money ◽  
Mark Perry ◽  
Julie Barnett ◽  
Terry Young
Keyword(s):  
Oral Anticoagulation ◽  
Anticoagulation Therapy ◽  
Oral Anticoagulation Therapy ◽  
Self Testing

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.

Management of epistaxis in patients on novel oral anticoagulation therapy

2020 ◽  
Vol 134 (4) ◽  
pp. 316-322
Author(s):  
J P K Ho ◽  
N Bari ◽  
F Riffat
Keyword(s):  
Oral Anticoagulation ◽  
Oral Anticoagulants ◽  
Anticoagulation Therapy ◽  
Efficacy And Safety ◽  
Oral Anticoagulation Therapy ◽  
Reversal Agents ◽  
Risk Of Bleeding ◽  
Increased Risk ◽  
Comprehensive Search ◽  
Anticoagulated Patients

AbstractBackgroundIndividuals on anticoagulation therapy are at increased risk of bleeding, including epistaxis. There is a lack of available reversal agents for novel oral anticoagulation therapy.ObjectiveThis paper reviews the current literature on epistaxis in the context of novel oral anticoagulation use, in order to recommend guidelines on management.MethodA comprehensive search of published literature was conducted to identify all relevant articles published up to April 2019.ResultsPatients on oral anticoagulation therapy are over-represented in individuals with epistaxis. Those on novel oral anticoagulation therapy were more likely to relapse compared to patients on classic oral anticoagulants or non-anticoagulated patients. Idarucizumab is an effective antidote for bleeding associated with dabigatran use. Recommendations for epistaxis management in patients on novel oral anticoagulation therapy are outlined.ConclusionClinicians need to be aware of the potential severity of epistaxis and the increased likelihood of recurrence. High-quality studies are required to determine the efficacy and safety of andexanet alfa and ciraparantag, as well as non-specific reversal agents.

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