CALL FOR A NATIONAL SERVICE DELIVERY MODEL
The petitioner is calling on the Scottish Parliament to urge the Scottish Government to implement a national service delivery model for warfarin patients who request the option to self-test or self-manage their condition. Currently no such model exists for Scotland’s 80,000 warfarin patients.
All warfarin patients require regular monitoring of international normalised ratio (INR): daily at the start of treatment and, once stable, every 6-12 weeks. INR monitoring is normally managed by local anticoagulant clinics, but suitable patients can be trained to self-test (where patients record their readings to send to clinicians to review) and/or self-manage their condition (where patients are completely responsible for their readings and dose). Both arrangements can be safe, reliable and more convenient for many patients.
It is imperative a national service delivery model is created to support suitable patients who wish to self-test or self-manage their condition. The petitioner is already working with Greater Glasgow and Clyde Health Board to create a local service delivery model for warfarin paediatric patients moving to adult services within the area. The petitioner believes a plan of this type should be developed at the national level for all warfarin patients, including those moving from paediatric to adult care services. Ultimately, the aim of this model would be to improve awareness, training and support for clinicians and warfarin patients who wish to self-test or self-manage. The petitioner believes a national service delivery model should incorporate the following:
An immediate review of those patients on warfarin who request the ability to self-test their INR and/or self-manage their condition:
Although there is funding for INR testing devices in Scotland, only 1% of people receiving warfarin therapy undertake self-testing. It is not clear why the number of patients self-testing is so low, or why suitable patients encounter resistance to self-test or self-manage. It could be attributed to a number of different factors, which will have very different consequences for what a national model should address and these issues must therefore be investigated.
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