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
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