Verification of the qLabs international normalized ratio point‐of‐care device for monitoring of patients attending an anticoagulation clinic

Mbokota, N.; Schapkaitz, Elise; Louw, Susan

doi:10.1111/ijlh.12849

Cited by 8 publications

(4 citation statements)

References 30 publications

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“…At least two different point-of-care (POC) INR monitors have been validated in South African patients, [89][90][91] and there have been reports of using POC INR monitors in ACCs in Namibia, [19] Kenya, [7,70,92,93] and Nigeria. [87] Considering only the cost per test, POC testing is more expensive than laboratory monitoring; however, it may be cost-effective in some settings.…”

Section: Challenges Accessing Anticoagulationmentioning

confidence: 99%

Improving anticoagulation in sub-Saharan Africa -- what are the challenges, and how can we overcome them?

Mouton

Blockman

Wiltshire

et al. 2020

Preprint

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Patients in sub-Saharan Africa generally have poor anticoagulation control. We review the potential reasons for this poor control, as well as the potential solutions. Challenges include the affordability and centralisation of anticoagulation care, problems with access to medicines and INR monitoring, the lack of locally-validated standardized dosing protocols, and low levels of anticoagulation knowledge among health care workers and patients. Increasing numbers of patients will need anticoagulation in the future because of the epidemiological transition in the region. We propose that locally-developed "warfarin care bundles" which address multiple anticoagulation challenges in combination may be the most appropriate solution in this setting currently.

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Section: Challenges Accessing Anticoagulationmentioning

confidence: 99%

Improving anticoagulation in sub-Saharan Africa -- what are the challenges, and how can we overcome them?

Mouton

Blockman

Wiltshire

et al. 2020

Preprint

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“…[30][31][32] With a lack of superiority of TEG and ROTEM over standard coagulation tests, POC versions of INR are being developed and studied in other patient populations, such as home warfarin monitoring in the case of POC-INR. 52 Prior studies in patients on cardiopulmonary bypass have shown concordance between near-patient PT/INR testing and central laboratory results, whereas near-patient aPTT testing was discordant. 40,53…”

Section: Discussionmentioning

confidence: 95%

An introduction to point-of-care testing in extracorporeal circulation and LVADs

Bercovitz

2018

Hematology

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There is a delicate balance between bleeding and clotting in patients on circuits such as ventricular assist devices or extracorporeal membrane oxygenation. Traditional coagulation tests, prothrombin time, activated partial thromboplastin time, and anti-factor Xa levels, are used to monitor patients on these devices. However, turnaround times and inability to assess global hemostasis, including platelets and fibrinogen have contributed to a recognition that faster, accurate, and more informative coagulation tests are needed. Activated clotting time is used to monitor heparin in patients on circuits and has the advantages of being a near-patient point-of-care test. However, its utility is limited to heparin monitoring. Viscoelastic tests (thromboelastometry and thromboelastography) are global, whole-blood coagulation tests, and whole-blood platelet aggregometry evaluates platelet function. Ideally, these tests can ensure that patients are within the therapeutic range of their antithrombotic medications, identify patients at risk for hemorrhagic or thrombotic complications, and guide management of acute bleeding complications. This ideal is currently hampered by a lack of studies that delineate clear ranges that are clinically relevant. Future research is needed to better understand the optimal use of point-of-care coagulation testing in patients on extracorporeal circuits and ventricular assist devices.

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“…At least two different point-of-care INR monitors have been validated in South African patients, [89][90][91] and there have been reports…”

Section: Changing Life Expectancy and Disease Burdenmentioning

confidence: 99%

“…At least two different point‐of‐care INR monitors have been validated in South African patients, 89 , 90 , 91 and there have been reports of using point‐of‐care INR monitors in anticoagulation clinics in Namibia, 19 Kenya 7 , 70 , 92 , 93 and Nigeria. 87 Considering only the cost per test, point‐of‐care testing is more expensive than laboratory monitoring; however, it may be cost‐effective in some settings, for example rural and remote settings.…”

Section: Challenges Accessing Anticoagulationmentioning

confidence: 99%

Improving anticoagulation in sub‐Saharan Africa: What are the challenges and how can we overcome them?

Mouton

Blockman

Sekaggya-Wiltshire

et al. 2021

Brit J Clinical Pharma

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Patients in sub-Saharan Africa generally have poor anticoagulation control. We review the potential reasons for this poor control, as well as the potential solutions.Challenges include the affordability and centralisation of anticoagulation care, problems with access to medicines and international normalised ratio monitoring, the lack of locally validated standardized dosing protocols, and low levels of anticoagulation knowledge among healthcare workers and patients. Increasing numbers of patients will need anticoagulation in the future because of the increasing burden of noncommunicable disease in the region. We propose that locally developed "warfarin care bundles" which address multiple anticoagulation challenges in combination may be the most appropriate solution in this setting currently.

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Verification of the qLabs international normalized ratio point‐of‐care device for monitoring of patients attending an anticoagulation clinic

Abstract: In conclusion, the qLabs POC device is accurate and precise with high levels of dosage concordance and clinical agreement for INR values within and below the target range.

Cited by 8 publications

References 30 publications

Improving anticoagulation in sub-Saharan Africa -- what are the challenges, and how can we overcome them?

Improving anticoagulation in sub-Saharan Africa -- what are the challenges, and how can we overcome them?

An introduction to point-of-care testing in extracorporeal circulation and LVADs

Improving anticoagulation in sub‐Saharan Africa: What are the challenges and how can we overcome them?

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