Point-of-care patient self-monitoring of oral vitamin K antagonist therapy.
Successful therapy with vitamin K antagonists requires maintaining a patient in the therapeutic international normalized ratio (INR) range for the particular indication under treatment. Achieving this is dependent on the model of dose management under which the therapy is provided. Most patients in the United States are managed by their individual physician and the time in therapeutic range (TTR) is often low. Patients who have monitored their therapy at home with a point-of-care INR monitor have demonstrated an ability to achieve a high rate of TTR as documented in clinical trials. Recently, similar or even better rates of TTR have been demonstrated in patients performing home monitoring outside of a clinical trial. These findings support the recommendations to implement home monitoring in those who have demonstrated competency in self-management strategies.
Department of medicine, Lenox Hill Hospital, New York, NY 10075, USA. jansell@lenoxhill.net
Jack
J
Ansell
D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D005260:Female; D006801:Humans; D019934:International Normalized Ratio; D008297:Male; D008991:Monitoring, Physiologic; D019095:Point-of-Care Systems; D012648:Self Care; D014481:United States; D014812:Vitamin K / Q000037:antagonists & inhibitors*; D014859:Warfarin / Q000009:adverse effects / Q000627:therapeutic use*
D000925:Anticoagulants; D014812:Vitamin K; D014859:Warfarin