title: Telemedicine can improve the quality of oral anticoagulation using portable devices and self-testing at home.
abstract: Point-of-care testing (POCT) devices can be used to monitor anticoagulant therapy. We compared patients being monitored at home by self-testing using a POCT device and telemedicine support with a previous period of conventional monitoring at a Thrombosis Centre. A total of 114 anticoagulated patients participated. The number of blood checks (INR) was significantly higher in the home monitoring group and the interval between checks was significantly shorter. The percentage of missed INR checks was significantly higher during the conventional monitoring period compared with home monitoring. Patients were divided into two groups on the basis of the time spent within the therapeutic range (TTR) during conventional monitoring: the unstable group had TTR<70% and the stable group had TTR ≥70%. In the unstable group there was a significant increase in TTR with home monitoring: 63% to 68% (P < 0.001) while in the stable group there was no significant change (77% to 75%). The study showed that oral anticoagulation management by means of self-testing is suitable and safe.
authors.affiliation: Department of Medical Sciences, University of Cagliari, Cagliari, Italy.
authors.forename: Doris
authors.initials: D
authors.lastname: Barcellona
authors.forename: Lara
authors.initials: L
authors.lastname: Fenu
authors.forename: Simona
authors.initials: S
authors.lastname: Cornacchini
authors.forename: Francesco
authors.initials: F
authors.lastname: Marongiu
mesh_terms: D015110:4-Hydroxycoumarins / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D000284:Administration, Oral; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D002908:Chronic Disease / Q000188:drug therapy; D005260:Female; D006801:Humans; D007192:Indenes / Q000008:administration & dosage / Q000097:blood / Q000627:therapeutic use*; D019934:International Normalized Ratio; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation; D019095:Point-of-Care Systems; D012648:Self Care / Q000295:instrumentation* / Q000379:methods; D017216:Telemedicine / Q000295:instrumentation*; D013923:Thromboembolism / Q000401:mortality / Q000517:prevention & control; D014812:Vitamin K / Q000008:administration & dosage / Q000037:antagonists & inhibitors* / Q000097:blood / Q000627:therapeutic use
chemical_list: D015110:4-Hydroxycoumarins; D000925:Anticoagulants; D007192:Indenes; C011664:antivitamins K; D014812:Vitamin K