title: STABLE results: warfarin home monitoring achieves excellent INR control.
abstract: OBJECTIVE
  Point-of-care, home international normalized ratio (INR) monitoring (patient self-testing, or PST) provides an opportunity to optimize warfarin therapy as demonstrated in randomized trials. This study sought to determine the quality of warfarin therapy as determined by time in therapeutic INR range (TTR) in patients who perform home monitoring outside of a clinical trial setting.
  
  
  METHODS
  Retrospective analysis.
  
  
  METHODS
  The data base of an independent diagnostic testing facility was retrospectively queried over a 2.5-year period (January 2008-June 2011) and patient TTR was analyzed based on frequency of testing, age, gender, indication for therapy, duration of therapy, and critical value occurrence.
  
  
  RESULTS
  A total of 29,457 patients with multiple indications for warfarin therapy comprised the database. The mean TTR for the entire group was 69.7%, with weekly testers achieving a TTR of 74% versus 68.9% for variable testers (testing every 2-4 weeks)(P <.0001). In all categories analyzed (age, indication for anticoagulation, and referral site volume), weekly testers performed significantly better than variable testers. Older individuals had a higher TTR than younger patients. Weekly testers experienced significantly fewer critical values (INR <1.5 or >5.0) than did variable testers.
  
  
  CONCLUSIONS
  Point-of-care patient self-testing at home achieves high-quality warfarin therapy outside of clinical trials and compares favorably with the results achieved in randomized trials or in anticoagulation clinic settings.
authors.forename: Grace
authors.initials: G
authors.lastname: DeSantis
authors.forename: Jackie
authors.initials: J
authors.lastname: Hogan-Schlientz
authors.forename: Gary
authors.initials: G
authors.lastname: Liska
authors.forename: Shari
authors.initials: S
authors.lastname: Kipp
authors.forename: Ramario
authors.initials: R
authors.lastname: Sallee
authors.forename: Mark
authors.initials: M
authors.lastname: Wurster
authors.forename: Kenneth
authors.initials: K
authors.lastname: Kupfer
authors.affiliation: 401 E 60th St, New York, NY 10022. E-mail: ansellje@gmail.com.
authors.forename: Jack
authors.initials: J
authors.lastname: Ansell
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000097:blood*; D015331:Cohort Studies; D016903:Drug Monitoring; D005260:Female; D006801:Humans; D019934:International Normalized Ratio; D008297:Male; D008875:Middle Aged; D019095:Point-of-Care Systems; D012189:Retrospective Studies; D012648:Self Care; D014481:United States; D014859:Warfarin / Q000097:blood*; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D014859:Warfarin