Many people, especially seniors are on Coumadin therapy. These people, who are in special danger of forming blood clots, have atrial fibrillation or may have had phlebitis, heart attacks, strokes or other illnesses where blood clots have been a factor, take daily doses of Coumadin which thins the blood to reduce the likelihood of blood clots. The two tests which measure the clotting ability of the blood are called PT and INR. (Protime and International Normalized Ratio.) The INR reading is normally used. For a better understanding of the testing, you may wish to read this Clotcare.org article. Monthly testing is very important as the clotting ability of the blood must be kept within a very narrow range. Until recently the testing required a trip to a lab, but home testing by the patient has now been approved by Medicare.
Tests May Need to be Made Weekly or Bi-Weekly If the Readings are Not Stable.
If the readings are not stable, the blood may be tested weekly or bi-weekly until the correct Coumadin dosage is determined. If the INR is too low, there is little protection from blood clots. If the INR is too high, the blood is too thin and a person could bleed to death, especially if involved in an accident. The generic name for Coumadin is warfarin, which is a very effective rat poison.
Home Testing is Very Appealing for Patients Who Have Problems Traveling
This testing can be very inconvenient for some people if they live a long distance from a testing lab or lack transportation. Now, home-testing by the patient is available if your doctor approves and writes a prescription. Your doctor needs to know you well and be convinced that you are mentally and physically capable and reliable enough that you can be trusted to responsibly check your own INR, because it is a ‘life and death matter.” A doctor who gave home testing permission to a patient who was incompetent would be in legal jeopardy himself.
Home Testing is Simple to Arrange If Your Doctor Agrees
I use the Alere Home Monitoring System. Their website supplies an information form to be completed by the patient and a prescription form which must be completed by their doctor. It may be more convenient to let your medical personnel handle the transition if they are agreeable.
I had been having my testing performed at the Anti-coagulation Clinic at a local hospital. I asked the nurses in charge of the clinic if I could participate in the home monitoring program. After I filled out the patient application form, they contacted my primary care doctor for a prescription allowing me to enroll in the Alere Home Monitoring Program. I felt gratified that my doctor felt I was qualified. An Alere representative called me and interviewed me for the program. Then they verified that Medicare would approve my participation.
Instruction Can Be Done in Your Home
In a short time, I received a letter from Alere stating that I was accepted in the program and a nurse from my clinic had been assigned to come to my home and train me to perform the test. The nurse did a fine job of explaining the procedure and guided me through the actual test. She made sure all my questions were answered and told me to call her with any later questions. After the test the patient is then expected to transmit the resulting INR reading to Alere by email or by using a push-button phone. Alere then faxes the reading to my clinic so that they can adjust my Coumadin dosage if the reading is out of range.
The Patient is Still Given Full Medical Support
The patient is not abandoned. My clinic still gives me total support in case I have any problems or questions. I still need to travel to the clinic every 3 months for a test to check on the accuracy of my monitor. I do have considerable confidence in the monitoring instrument because it is the same model the clinic uses. I use the “CoaguChek” model. The patient does not own the monitor and must return it to the company if they leave the program.
My only complaint is the design of the disposable test strip, which is like a glucose monitor test strip but is much larger. It is much harder to use than a glucose test strip, which easily siphons the blood into the tip of the test strip. The INR test strip requires a larger blood specimen which must be placed in the center of the strip instead of on the tip. You may waste several test strips while learning to use the monitor but the problem can be overcome with practice. I believe the company expects that you will waste strips because they allow you 52 per year.
Since I have now learned to use the test strip, I am very pleased that I don’t need to travel to the clinic all the time. This would be especially nice if I happen to be traveling when my test is due, so I would not need to find a laboratory to perform the test. I believe home testing is a much more efficient method of providing health care and is much better for the patient in several ways.
Disclaimer: I am not a doctor or health care professional. This article is for informational purposes only. It is not the purpose of this article to give medical advice. I am only relating my opinions and experiences and my opinions could be wrong. Any actions you take or do not take as a result of reading this article, you take at your own risk. Always seek advice from a doctor or health care professional before making any health care decisions.
