Accuracy, Clinical Correlation, and Patient Acceptance of Two Handheld Prothrombin Time Monitoring Devices in the Ambulatory Setting

Chapman, Derek C; Stephens, Mark; Hamann, Gale L.; Bailey, Lamar E; Dorko, Craig

doi:10.1345/aph.18317

Cited by 40 publications

(23 citation statements)

References 20 publications

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“…If all Coaguchek S™ device measurements above 3.5 INR were repeated in the central laboratory this value would drop to 10%. This value agrees with the study published by Chapman and associates 20 where an 8% margin of error was found for medical decisions based on the Coaguchek™ system.…”

Section: Discussionsupporting

confidence: 92%

Controle do tempo de protrombina em sangue capilar e venoso em pacientes com anticoagulação oral: correlação e concordância

Leiria¹,

Pellanda²,

Magalhães³

et al. 2007

Arq. Bras. Cardiol.

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Section: Discussionsupporting

confidence: 92%

Controle do tempo de protrombina em sangue capilar e venoso em pacientes com anticoagulação oral: correlação e concordância

Leiria¹,

Pellanda²,

Magalhães³

et al. 2007

Arq. Bras. Cardiol.

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“…It is not rational to use the POC devices for routine INR monitoring because it may cause tromboembolic events result- ing from lower doses of warfarin therapy according to false high levels of INR. The ProTime monitor has been shown to correlate well with laboratory testing of INR with correlation coefficients on the order of 86-93% in some studies [7][8][9][10] whereas some studies explain the poor INR correlation between various POC systems and laboratory methods [8;9]. Similarly, the results of our study, do not correlate between POC devices and central laboratory results especially INR values greater than 2.0.…”

Section: Discussioncontrasting

confidence: 40%

The Success of Self-Testing for Anticoagulation Therapy

Songur¹

2014

Ann Clin Anal Med

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ÖzetAmaç: Varfarin tedavisinin optimum olabilmesi için gerekli olan terapötik INR (International normalized ratio) aralığı oldukça dardır. Sık kontrol gerektiren doz ayarının yapılabilmesi için çok çeşitli yöntemler mevcuttur. Bu çalışma-nın amacı; kişisel ölçüm cihazlarının doz ayarlanmasının yapılmasında ne kadar güvenli olduğunun tespit edilmesidir. Gereç ve Yöntem: Herhangi bir sebeple varfarin tedavisi alan 46 hasta çalışmaya dahil edildi. Hastaların yaşla-rı 24-84 aralığında değişmekte idi. 26 hasta erkek, 20 hasta ise kadındı. Hastalar laboratuvar INR sonuçlarına göre 3 gruba ayrıldılar. Grup 1: INR değeri 2,0'ın altında olan, grup 2: INR değeri 2,0-3,5 , grup 3: INR değeri 3,5 ve üze-rinde olan hastalardan oluşturuldu. Her üç grupta sırasıyla 15, 16, 15 hasta vardı. Hastalara parmak ucu kanından kişisel ölçüm cihazı ile INR kontrolü yapıldı. INR sonuçlarının etkileneceği etmenler göz önünde bulundurularak, üç grupta ortalama yaş, cinsiyet, hematokrit değeri, trombosit sayısı, kullanılan ilaçlar açısından istatistiksel anlamlı bir farklılık yoktu. Bulgular: Birinci grubun laboratuvar ölçümlerinde INR ortalaması 1.26 iken kişisel ölçüm cihazın-da ölçülen ortalama INR değeri 1.45 olarak tespit edildi ve her iki grup arasın-da istatistiksel anlamlı bir fark bulunamadı (p=0.15). İkinci grubun laboratuvar ölçümlerinde tespit edilen INR ortalama INR değeri 2.74 iken cihazda tespit edilen ortalama INR değeri 3.51 olarak tespit edildi (p=0.01). Üçüncü grubun laboratuvar cihazıyla tespit edilen ortalama INR değeri 4.27 iken cihazda tespit edilen ortalama değer 5.25 olarak tespit edildi (p=0.01). Tartışma: Varfarin tedavisinin sebep olacağı hemorajik ve tromboembolik komplikasyonların önlenmesi açısından, INR doz ayarlanmasının düzenli aralıklarla, uzman kişiler tarafından ve hastanelerde yapılmasının uygun olacağını savunuyoruz. Grup 1 had INR results lower than 2, group 2 had INR levels of 2 to 3.5, group 3 had INR levels of higher than 3.5 INR of the patients were remeasured with the POC device. Results: The ages of the patients were between 24 to 84. Twenty six patients were male and 20 were female. The mean INR level of laboratory measurements was 1.26 in group 1 whereas it was 1.45 for POC device measurements. There were not statistically significant difference between two devices for group 1 (p=0.15). In group 2 the mean INR levels were measured by laboratory instrument and POC device were 2.74 and 3.51 respectively (p=0,01). In group 3 mean INR levels were measured by laboratory instrument and POC device were 4.27 and 5.25 respectively (p=0.01). Anahtar KelimelerDiscussion: We suppose it is rational to adjust warfarin dosage by specialists using laboratory results in order to prevent hemorrhagic and thromboembolic complications.

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“…Of all the conducted measurement the dosage of VKA would have to be changed in 8.0-25% of the cases due to the inaccuracy of the CoaguChek R coagulometer [59,71,72,80,81]. Many of the studies displayed in Table 3 have not used optimal designs, e.g.…”

Section: Measurement Of Inrmentioning

confidence: 99%

Self-Management of Oral Anticoagulant Therapy: A Review

Christensen

2004

J Thromb Thrombolysis

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Patient self-management of oral anticoagulant therapy has over the last years gained increasing attention and widespread use. The method implies self-testing using a coagulometer (point-of-care device) and self-dosaging of coumarin. The method entails advantages for selected patients, who do not need to go to the hospital or family doctor for blood specimen and drug dosage adjustment. In contrast to patients on conventional management, patients performing self-managing have a reduced binding to the health care system, and it allows these patients unhindered to travel and manage their job or school. Therefore, the patients have a high degree of compliance because they are highly motivated. This has been the main justification for patient self-management. Furthermore, the conducted trials have also indicated a better quality of treatment compared to conventional management. In this paper the different aspects of this new treatment modality are critically reviewed, with special focus on the published clinical studies and the evaluation of the used coagulometers.

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Accuracy, Clinical Correlation, and Patient Acceptance of Two Handheld Prothrombin Time Monitoring Devices in the Ambulatory Setting

Abstract: The Coaguchek was superior to the ProTime Microcoagulation System in accuracy, clinical correlation, and ease of use. The study also showed that patients preferred capillary blood sampling by finger puncture over venipuncture for INR monitoring.

Cited by 40 publications

References 20 publications

Controle do tempo de protrombina em sangue capilar e venoso em pacientes com anticoagulação oral: correlação e concordância

Controle do tempo de protrombina em sangue capilar e venoso em pacientes com anticoagulação oral: correlação e concordância

The Success of Self-Testing for Anticoagulation Therapy

Self-Management of Oral Anticoagulant Therapy: A Review

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