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INR self-monitoring

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Dec 15, 2021

INR self-monitoring is used by patients on long-term and on lifetime anti-coagulation therapy to measure their INR (International Normalized Ratio) levels themselves, rather than at a clinic. People who self-monitor their INR levels use a portable INR monitor, as in a clinic, to take and test a drop of blood, drawn from a finger at scheduled times, and record the INR level measured by the monitor; moreover, the patient can either self-test or self-manage.

This article contains content that is written like an advertisement. (June 2019)
INR self-monitoring
Purpose self measure their INR (due to anti-coagulation therapy)

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People on anti-coagulation therapy who are self-testing provide the INR reading they obtain from their monitor to their healthcare professionals at an agreed time, generally by telephone. The healthcare professional decides if any change to the warfarin dose is required and lets the person know what action is needed. A PT/INR meter can be obtained by contacting an Independent Diagnostic Testing Facility (IDTF).[1] They are able to provide patients with all necessary testing equipment and bill the insurance for test results reported.[citation needed]

People who self-manage adjust their warfarin doses themselves, following training with their healthcare professional. This means that if the INR reading obtained from their monitor is out of the normal therapeutic range, they are able to make an adjustment to their own warfarin dose by themselves.[citation needed]

International normalized ratio (INR) which is a derivative of prothrombin time is a measurement of blood coagulation in the circulatory system. Both are used to determine the clotting rate of blood which can be affected by anticoagulant usage, liver damage and Vitamin K levels. The preferred range of INR levels for patient on anticoagulation therapy is usually between 2 and 3, but it tends to vary depending on the patient’s requirements.[citation needed]

Patients who self-monitor tend to choose this route for the greater control they feel it gives them over their lives and their condition. This helps to reduce the number of visits being made to their anticoagulation clinic for routine appointments to measure their INR levels. This is a lengthy process in comparison to self-testing and management. Results of clinical studies, which have been recognised by the National Patients Safety Authority (NPSA), show that people who self-monitor keep more frequently within their therapeutic range and have fewer complications including clots and bleeding, compared with people who have their INR levels tested only at their anticoagulation clinic.[citation needed]

Patient self-care is a key initiative in the NHS Plan for a patient centred health service and an important component in supporting people with long-term conditions.[2] It is seen to provide:

  • Better symptom management [3]
  • Improved feeling of wellbeing
  • Increase in life expectancy
  • Improvement in quality of life with greater independence [4]

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