A comparative study of anticoagulant control in patients on long-term warfarin using home and hospital monitoring of the international normalised ratio
2008
Background: Capillary whole blood point of care PT-INR testing at home is an alternative to hospital based monitoring for patients on life long warfarin.
Aim: To retrospectively assess the safety and efficacy of home point of care testing on children on long term warfarin. Method: All patients who had been on point of care home monitoring for at least six months were included in the study. Their warfarin control was assessed whilst on home monitoring and compared to that achieved in a similar period prior to changing from hospital monitoring.
Results: 37 patients were studied for mean of 1.0 year on clinic monitoring and 1.07 years on home monitoring. The clinic monitoring tests were within therapeutic range for a median 70.0 (inter-quartile range 34.5) and the home monitoring were within range for median 75.0 (inter-quartile range 44.5). There were no major haemorrhagic or thrombotic complications in either group during the study period. Only 2.3% of all tests had INR>6.0 with no statistical difference between the clinic and home monitoring groups.
Conclusion: Home point of care testing in children on life long warfarin is safe, effective and offers a number of advantages to the child and family. Ongoing training and support for the families is essential to provide this service.
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