Anticoagulation-Patient Self Testing versus Venipucture and Lab testing

As both methods provide advantages and disadvantages to clinics and patients, both methods need to be analyzed carefully.

Advantages for the patient:

The use of point of care devices such as Roche's Coaguchek and ProTime's PT/INR has the following advantages:

• Significant time saver

  • Traveling to and from a site can take up 190 minutes, more if the site is far.

• Results are immediate

  • Patient does not have to wait for a phone call from the lab or clinic

• Much less invasive than a venipuncture

• In our experience patients who self test tend to have a higher involvement managing their therapy.They are more compliant in terms of taking the medication and adjusting their diet to stay within range.

• If results are within range, and the patient has been properly educated it is possible that the patient start self managing dosages.

Disadvantages for the patient

• The monitor and strips may be out of pocket expenses for the patient. Some insurance plans cover these costs.

Advantages for the clinic

• More patients can be processed per day

  • Less ''chatting'' since the patient does not come physically

  • No need for receptionist, waiting room etc.

• Results are available as soon as taken by the patient

• Compliant patients are easier to manage

  • They tend to be within range, which means the patient interview takes less time

Disadvantages for the clinic

• Patients who phone in their results may expect to be dealt with right away. This may be a challenge to the work flow

• For results sent in by email, if the recipient is not present at the clinic it may mean processing delays

• A patient web-access to the application may alleviate these

An interesting study on patient self testing can be found here:  http://www.protimesystem.com/support/Patients_Experience_with_Home.pdf