The benefits of self-monitoring for people on long term warfarin

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It has been shown that 77% of people taking warfarin preferred patient self-monitoring to the usual model of care1 and that fewer consultations and hospital admissions are required when self-monitoring2. In short, self-monitoring enables:

  • People taking warfarin to spend greater time in their therapeutic range
  • The ability to test their INR when it is convenient to them
  • Better health outcomes as it reduces the risk of blood clots and bleeding
  • Freedom to travel for business or pleasure
  • People to stay in control of their life

It is essential for those on long term warfarin to have their blood tested on a regular basis. Those who are not self-monitoring are likely to be attending a hospital clinic or GP surgery for their INR to be tested and warfarin dose adjusted as required.

Making regular visits to appointments can get in the way of normal life, disrupt work or school commitments and interfere with holiday plans. Furthermore, some clinics overseas may charge for INR testing. Compared with regular trips to an anticoagulation clinic or doctors surgery, self-monitoring offers considerable benefits for both those on long term warfarin and the service provider.

Self-monitoring allows people to safely monitor and record their INR results at home, or any other convenient location. This may reduce the number of appointments that need to be attended, saving both time and money and allowing people more freedom to do the things they want to do.

In addition to this, there are considerable health benefits. Patient self-care is a key initiative in the NHS and self-monitoring is a part of this. There is better symptom managementTM and an improved feeling of wellbeing

  • People’s INR is more stable through spending more time in the INR therapeutic range1
  • People are at less risk as self-monitoring reduces the risk of thromboembolic events by 49%1
  • Self-monitoring offers particular benefits in those younger than 55 years, in whom the likelihood of developing thromboembolic events is reduced by two-thirds, and patients with a mechanical heart valve, where risk is halved1
  • Self-monitoring lowers mortality and does not increase complications in people aged 85 and older, who are at high risk of major bleeding, which suggests that age should not be a factor in determining eligibility for self-management1

A 2011 Survey4 of people on long-term warfarin, sponsored by two of the UK’s leading patient charities: AntiCoagulation Europe (ACE) and Atrial Fibrilation Association (AFA), in conjunction with the healthcare company Roche, revealed a lack of awareness about self-monitoring. It was revealed that:

  • More than half of those not using INR testers did not know they existed, despite the medical and quality of life benefits for people on long term warfarin
  • More than nine out of ten people wanted to be more involved and consulted in care decisions. However, the majority of people were not aware of the current NHS actions to involve patients in care decisions
  • 70% of people on long term warfarin found regular clinic visits inconvenient

Read more about the importance of self-monitoring, inspirational stories and the benefits of self-monitoring to the NHS.

1 Gardiner C et al, Patient self-testing is a reliable and acceptable alternative to laboratory INR monitoring, British Journal of Haematology, 2004
2 Self-care strategy: Self-care – a real choice. Department of Health, 2005
3 Heneghan C et al, Self-monitoring of oral anticoagulation: systematic review and meta-analysis of individual patient data, The Lancet, Volume 379, Issue 9813, 28 January–3 February 2012, Pages 322–334
4 Data on file Atrial Fibrilation Association , AntiCoagulation Europe 2011

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