Premium
Barriers to Patient Self‐Testing of Prothrombin Time: National Survey of Anticoagulation Practitioners
Author(s) -
Wittkowsky Ann K.,
Sekreta Colleen M.,
Nutescu Edith A.,
Ansell Jack
Publication year - 2005
Publication title -
pharmacotherapy: the journal of human pharmacology and drug therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.227
H-Index - 109
eISSN - 1875-9114
pISSN - 0277-0008
DOI - 10.1592/phco.25.2.265.56949
Subject(s) - medicine , reimbursement , warfarin , prothrombin time , family medicine , emergency medicine , medical emergency , surgery , health care , atrial fibrillation , economics , economic growth
Oral anticoagulation with warfarin requires routine monitoring of prothrombin time, expressed as the international normalized ratio (INR). Patient self‐testing for INR is common in Europe but not in the United States. In order to determine the frequency of INR self‐testing among patients whose anticoagulant therapy is managed in U.S. anticoagulation clinics, to describe the processes that support this self‐testing, and to identify the barriers as experienced by anticoagulation clinic providers, a three‐part survey was mailed to 538 anticoagulation specialists in the United States. The response rate was 43.7%. Policies and procedures of almost 60% of anticoagulation clinics prohibited INR self‐testing for enrolled patients. In addition, less than 1% of patients being managed by U.S. anticoagulation clinics use self‐testing to obtain INR results. Primary barriers were the cost of self‐testing instruments (78.7% of respondents), cost of reagent cartridges (60.4%), and fear that self‐testing might lead to unintended self‐management (35.7%). Over 75% of respondents believed that some reimbursement for the cost of self‐testing devices and supplies would increase the likelihood that anticoagulation clinics would recommend INR self‐testing.