Self-monitoring and self-management
It is essential for people on long term anticoagulation therapy, such as warfarin, to have their blood tested on a regular basis. People who are measuring their INR themselves, rather than having regular tests at a GP surgery or hospital clinic are said to be self-monitoring. People who self-monitor use a portable INR tester to take simple blood test, they take a small drop of blood from their finger and report the readings to their doctor or nurse. A person can either self-test or self-manage.
People who are self-testing inform their doctor or nurse of the INR reading from their tester at an agreed time. They are then advised by their doctor or nurse if a dose adjustment is necessary. People who self-manage adjust their warfarin dose themselves following training with their doctor or nurse.
People on long term warfarin are at increased risk of complications such as blood clots or excessive bleeding if their international normalised ratio (INR) is not regulated properly. The clotting pathway is affected by diet and other factors such as usage of other medications.
Blood tests to check INR levels are required at regular intervals, these are determined by the doctor or nurse. For many this involves either visiting a warfarin clinic in hospital or at the doctor’s surgery, or visiting a pharmacist led clinic at the chemist. In some cases this can involve a venous sample from the arm and then waiting for hours for a result.
Patient self-monitoring enables people to test at home and liaise with their doctor or nurse by telephone, email, text or fax, therefore saving valuable time for both parties.