Home anticoagulation testing: predictors of rural patient interest.
BACKGROUND
Home anticoagulation testing (HAT) may be useful for rural patients who cannot attend an anticoagulation service clinic (ASC). Interest in HAT is unknown and was the focus of this study.


METHODS
Anticoagulated patients from two clinics, the ASC and vascular surgery clinic (VSC) were surveyed and compared for demographics, anticoagulation knowledge and opinions, and HAT interest. Logistic regression was performed, using the entire patient cohort, to identify factors associated with HAT interest.


RESULTS
There were 211 (141 ASC, 70 VSC) patients surveyed. Differences between the ASC and VSC patients included education level (13.2 versus 12.1 years; P = 0.02), time spent testing (60.5 +/- 33.5 versus 46.4 +/- 20.7 min; P = 0.001), use of fingerstick testing (90% versus 2.9%; P < 0.001), and knowledge of the potential interaction of warfarin with medications or diet (79% versus 59% P = 0.003). HAT interest was similar (62.1% ASC versus 50% VSC; P = 0.14). Factors associated with HAT interest included employment [odds ratio (OR) 2.9, 95% confidence interval (CI) 1.2-6.7], knowledge of potential interactions between medications and warfarin (OR 3.9, 95% CI 1.9-8.1), and a willingness to check international normalized ratio values more frequently if recommended (OR 2.4, 95% CI 1.2-4.6). Patients who received family help with medications appeared less interested in HAT (OR 0.29, 95% CI 0.12-0.68).


CONCLUSIONS
A slight majority of surveyed rural patients conveyed interest in HAT. Working patients and those assuming more responsibility for international normalized ratio control may be more interested in HAT. A possible association between anticoagulation knowledge and increased HAT interest was seen and should be further studied.
Quin
Jacquelyn
J
Department of Surgery, Southern Illinois University School of Medicine, Springfield, Illinois 62794-9638, USA. jquin@siumed.edu
Markwell
Stephen
S
Rogers
Laura Q
LQ
McLafferty
Robert
R
Reinersman
Matthew
M
Hazelrigg
Stephen
S
D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use*; D001780:Blood Coagulation Tests / Q000295:instrumentation* / Q000379:methods; D003625:Data Collection; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D017060:Patient Satisfaction; D011237:Predictive Value of Tests; D012424:Rural Population; D012648:Self Care / Q000295:instrumentation / Q000379:methods; D013927:Thrombosis / Q000188:drug therapy / Q000517:prevention & control*; D014859:Warfarin / Q000627:therapeutic use*
D000925:Anticoagulants; D014859:Warfarin