ACSMA has today welcomed new guidance from the National Institute for Health and Care Excellence (NICE) which recommends two self-monitoring devices for NHS use by people on long-term warfarin therapy.
NICE has recommended the CoaguChek XS system and the INRatio2 PT/INR monitor (devices known as coagulometers) on the NHS for adults and children with atrial fibrillation or heart valve disease if the person prefers this form of testing and the person or their carer is both physically and cognitively able to self-monitor effectively.
The NICE guidance comes only a week after the Government published it response to a House of Commons Health Select Committee report into the management of long-term conditions, stressing the importance of self-management and noting that better use of technology in the NHS can empower patients, improve communication between services and deliver efficiencies and savings for the NHS.
Eve Knight, Chief Executive of AntiCoagulation Europe and ACSMA member said; “We are delighted that NICE has concluded that self-monitoring with these devices is a clinically- and cost-effective use of NHS resources. We know of hundreds of patients who would welcome the opportunity to self-monitor their INR levels and we hope that today’s guidance will bring us one step closer to making self-monitoring devices available on prescription so that more and more patients who wish to self-monitor their INR have the opportunity to do so.”
Unfortunately, not everyone on long-term warfarin is expected to get access to the devices. ACSMA recently produced a report which revealed that two-thirds of CCGs in England do not allow or support INR self-monitoring in their area. This means that the vast majority of people on long-term warfarin are being denied the opportunity to self-monitor, despite the benefits to the patient in terms of health outcomes, convenience and quality of life, and the long-term cost savings to the health service.ACSMA welcomes NICE Guidance
Eve continued: “Self-monitoring is a win-win situation; a win for the NHS as it can help reduce the number of potentially life-threatening strokes and save money, and a win for the patient who benefits from greater independence and the choice to take control of his or her own long-term health condition. We would encourage CCGs to look at the guidance closely and incorporate its recommendations into their anticoagulation service at the earliest opportunity, so that the benefits of self-monitoring can be offered to as many people as possible.”
ACSMA. Anticoagulation services and patient access to INR self-monitoring in the NHS in England. 2014.
Connock M, Stevens C, Fry-Smith A, Jowett S, Fitzmaurice D, Moore D, et al. Clinical effectiveness and cost-effectiveness of different models of managing long-term oral anticoagulation therapy: a systematic review and economic modelling [online]. Health Technol.Assess. 2007 ix-66; Oct;11(38):iii-iv, ix-66.