scholarly journals Factors determining patients' intentions to use point-of-care testing medical devices for self-monitoring: the case of international normalized ratio self-testing

2012 ◽  
pp. 1 ◽  
Author(s):  
Syed Ghulam Sarwar Shah ◽  
Barnett ◽  
Jasna Kuljis ◽  
Kate ◽  
Richard
Keyword(s):  
Medical Devices ◽  
Point Of Care ◽  
International Normalized Ratio ◽  
Point Of Care Testing ◽  
Self Monitoring ◽  
Self Testing

Point-of-care testing INR: an overview

2017 ◽  
Vol 55 (6) ◽  
pp. 800-805 ◽  
Author(s):  
Doris Barcellona ◽  
Lara Fenu ◽  
Francesco Marongiu
Keyword(s):  
Point Of Care ◽  
Cost Effective ◽  
International Normalized Ratio ◽  
Point Of Care Testing ◽  
Mechanical Valves ◽  
Self Testing ◽  
Periodic Monitoring ◽  
Monitoring Test ◽  
Pros And Cons

Abstract Oral anticoagulant therapies with the anti-vitamin K drugs (AVK), warfarin, acenocoumarol and phenprocoumon, are employed in primary and secondary anti-thrombotic prophylaxis in patients with venous thromboembolism, atrial fibrillation and cardiac mechanical valves. However, a monitoring test such as the International Normalized Ratio (INR) is required. The periodic monitoring of this therapy entails discomfort for the patients. Telemedicine and telecare can provide significant aid in the management of this therapy allowing patients to perform the test at home or anywhere else with a portable device, i.e. point-of-care testing (POCT), and to send the result to a thrombosis (TC) via web. Patients can receive dose adjustment sent back by the TC. The effectiveness of this type of management is equal or superior to the traditional AVK monitoring in terms of hemorrhagic and thrombotic events. Analysis of the costs with a horizon of 10 years reveals that both self-testing and self-management are cost-effective. The aim of this overview is to describe the pros and cons of the use of POCT as an alternative in the monitoring of AVK. In particular, description of the POCT, decentralization, quality of the therapy, safety and costs will be examined.

scholarly journals Point-of-Care Testing of International Normalized Ratios for People on Oral Anticoagulants: A Rapid Qualitative Review

2021 ◽  
Vol 1 (3) ◽  
Author(s):  
Elijah Herington ◽  
Danielle MacDougall
Keyword(s):  
Point Of Care ◽  
Oral Anticoagulants ◽  
Community Pharmacists ◽  
International Normalized Ratio ◽  
Health Needs ◽  
Point Of Care Testing ◽  
Anticoagulation Management ◽  
Personalized Care ◽  
Ongoing Training ◽  
Self Testing

The opportunity to engage in self-testing can be experienced as simultaneously liberating and constraining. While self-testing may be appreciated as a form of point-of-care testing for international normalized ratio (INR) levels, some people engaged in self-testing were concerned with the limited amount of personalized care they received. People using oral anticoagulants described community pharmacist-led anticoagulation management services (CPAMS) as a convenient way of testing INR levels and learning about their health needs. Community pharmacists felt they were well-situated to provide care through CPAMS, but acknowledged the importance of ongoing training, oversight, and appropriate levels of resourcing.

scholarly journals Point-of-care coagulation testing for reducing in-hospital delay in thrombolysis

2018 ◽  
Vol 26 (4) ◽  
pp. 218-224 ◽  
Author(s):  
Jung Hee Han ◽  
Seongsoo Jang ◽  
Mi-Ok Choi ◽  
Mi-Jeong Yoon ◽  
Seung-Bok Lim ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Prothrombin Time ◽  
Laboratory Testing ◽  
Point Of Care ◽  
Intravenous Thrombolysis ◽  
International Normalized Ratio ◽  
Interquartile Range ◽  
Time Interval ◽  
Central Laboratory ◽  
Point Of Care Testing

Background: The confirmation of prothrombin time international normalized ratio by a central laboratory often delays intravenous thrombolysis in patients with acute ischemic stroke. Objectives: We investigated the feasibility, reliability, and usefulness of point-of-care determination of prothrombin time international normalized ratio for stroke thrombolysis. Methods: Among 312 patients with ischemic stroke, 202 who arrived at the emergency room within 4.5 h of stroke onset were enrolled in the study. Patients with lost orders for point-of-care testing for the prothrombin time international normalized ratio or central laboratory testing for the prothrombin time international normalized ratio (n = 47) were excluded. We compared international normalized ratio values and the time interval from arrival to the report of test results (door-to-international normalized ratio time) between point-of-care testing for the prothrombin time international normalized ratio and central laboratory testing for the prothrombin time international normalized ratio. In patients who underwent thrombolysis, we compared the time interval from arrival to thrombolysis (door-to-needle time) between the current study population and historic cohort at our center. Results: In the 155 patients included in the study, the median door-to-international normalized ratio time was 9.0 min (interquartile range, 5.0–12.0 min) for point-of-care testing for the prothrombin time international normalized ratio and 46.0 min (interquartile range, 38.0–55.0 min) for central laboratory testing for the prothrombin time international normalized ratio (p < 0.001). The intraclass correlation coefficient between point-of-care testing for the prothrombin time international normalized ratio and central laboratory testing for the prothrombin time international normalized ratio was 0.975 (95% confidence interval: 0.966–0.982). Forty-nine of the 155 patients underwent intravenous thrombolysis. The door-to-needle time was significantly decreased after implementation of point-of-care testing for the prothrombin time international normalized ratio (median, 23.0 min; interquartile range, 16.0–29.8 vs median, 46.0 min; interquartile range, 33.5–50.5 min). Conclusion: Utilization of point-of-care testing for the prothrombin time international normalized ratio was feasible in the management of patients with acute ischemic stroke. Point-of-care testing for the prothrombin time international normalized ratio was quick and reliable and had a pivotal role in expediting thrombolysis.

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.

Recent progress, challenges, and prospects of fully integrated mobile and wearable point-of-care testing systems for self-testing

2020 ◽  
Vol 49 (6) ◽  
pp. 1812-1866 ◽  
Author(s):  
Sajal Shrivastava ◽  
Tran Quang Trung ◽  
Nae-Eung Lee
Keyword(s):  
Recent Progress ◽  
Point Of Care ◽  
Form Factors ◽  
Treatment Decisions ◽  
Point Of Care Testing ◽  
Fully Integrated ◽  
Self Testing ◽  
New Form ◽  
Rapid Treatment

POCT systems have been developed toward new form factors as wearable and mobile POCT. New advancements in these POCT systems may provide self-testing capability for on-the-spot diagnosis and monitoring to facilitate rapid treatment decisions.

Point-of-care testing of the international normalized ratio in patients with antiphospholipid antibodies

2005 ◽  
Vol 94 (12) ◽  
pp. 1196-1202 ◽  
Author(s):  
Gregory P. Samsa ◽  
Thomas L. Ortel ◽  
Stephanie L. Perry
Keyword(s):  
Atrial Fibrillation ◽  
Whole Blood ◽  
Antiphospholipid Antibodies ◽  
Point Of Care ◽  
International Normalized Ratio ◽  
Absolute Difference ◽  
Factor X ◽  
Point Of Care Testing ◽  
Laboratory Plasma ◽  
Finger Stick

SummaryAntiphospholipid antibodies can influence the results of clotting tests in a subset of patients, which can be a major obstacle in monitoring warfarin. The aim was to determine if point-of-care testing of the International Normalized Ratio (INR) is influenced by antiphospholipid antibodies. We compared 59 patients receiving warfarin for a diagnosis of antiphosphoipid antibody syndrome (APS) to 49 patients receiving warfarin for atrial fibrillation to evaluate the consistency between INR results obtained by different methods. INR results obtained by finger stick (capillary whole-blood) and venipuncture (non-citrated and citrated whole-blood) were compared with our laboratory plasma-based prothrombin time assay. Five patients (8%) with APS and both elevated anti-β2glycoprotein I levels and positive lupus anticoagulants had non-measurable ProTime® INR results and generally higher Hemochron® Signature INR results than the plasma-based method, but the corresponding chromogenic factor X results were not supratherapeutic. For the remaining patients, differences between the plasma-based INR and the point-of-care INR results ranged from 0.2±0.2 to 0.4±0.3. The differences were similar for patients with APS and atrial fibrillation for all INR comparisons with the exception of the plasma-based method compared with the ProTime, which showed a mean absolute difference of 0.4±0.3 for APS patients and of 0.2±0.2 for atrial fibrillation patients (p=0.02). In a subset ofAPS patients, the ProTime® system will not yield an INR result and the HEMochron Signature (citrate and non-citrate whole-blood) INR results will exhibit elevated INR results. For this subset of APS patients, we suggest using an alternative method to monitor warfarin.

scholarly journals Peningkatan Derajat Kesehatan Masyarakat Melalui Pemeriksaan Kesehatan dan Edukasi Pola Hidup Sehat

2019 ◽  
Vol 4 (1) ◽  
pp. 376-382
Author(s):  
Puspitasari Puspitasari ◽  
Evi Rinata ◽  
Agus Salim
Keyword(s):  
Public Health ◽  
Community Service ◽  
Medical Devices ◽  
Point Of Care ◽  
The Elderly ◽  
Observation Point ◽  
Healthy Lifestyles ◽  
Point Of Care Testing ◽  
To Come ◽  
Disease Community

Improving the level of public health can be started by increasing sufficient knowledge about healthy lifestyles. The period of the elderly is a period of life that needs attention because this period is susceptible to disease. Community service activities aim to broaden the views on the importance of health for the elderly. This activity was carried out at the elderly Posyandu, Jiken Village, Tulangan, Sidoarjo in March to April 2019. The method used was observation, Point of Care Testing (POCT) training for Posyandu cadres, counseling and consultation regarding healthy lifestyles. The result of this activity is that Posyandu cadres can do Point of Care Testing (POCT) and can implement it continuously because the simple medical devices they have are complete. In addition, the elderly people are increasingly enthusiastic to come to the posyandu. This can be seen from the list of visits and activeness of the elderly in participating in the whole series of activities while in the posyandu.  

Comparison of point-of-care testing (POCT): i-STAT® international normalized ratio (INR) vs reference laboratory INR in pediatric patients undergoing major surgery

2011 ◽  
Vol 21 (10) ◽  
pp. 1041-1045 ◽  
Author(s):  
Nelly Spielmann ◽  
Jacqueline Y. Mauch ◽  
Caveh Madjdpour ◽  
Markus Schmugge ◽  
Manuela Albisetti ◽  
...  
Keyword(s):  
Pediatric Patients ◽  
Point Of Care ◽  
International Normalized Ratio ◽  
Major Surgery ◽  
Reference Laboratory ◽  
Point Of Care Testing
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