BACKGROUND: Capillary whole-blood point-of-care prothrombin-INR (PT-INR) testing at home is an alternative to hospital-based monitoring for patients on lifelong warfarin. AIM: To retrospectively assess the safety and efficacy of home point-of-care testing for children on long-term warfarin. METHOD: All patients who had been on point-of-care home monitoring for at least 6 months were included in the study. Their warfarin control was assessed while on home monitoring and compared to that achieved in a similar period before changing from hospital monitoring. RESULTS: Thirty-seven patients were studied for a mean of 1.0 year on clinic monitoring and 1.07 years on home monitoring. The clinic monitoring tests were within a 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 an INR greater than 6.0 with no statistical differences seen between the clinic and home monitoring groups. CONCLUSION: Home point-of-care testing in children on lifelong warfarin is safe, effective and offers a number of advantages to the child and family. Ongoing training and support for the families is essential for this service.
BACKGROUND: Capillary whole-blood point-of-care prothrombin-INR (PT-INR) testing at home is an alternative to hospital-based monitoring for patients on lifelong warfarin. AIM: To retrospectively assess the safety and efficacy of home point-of-care testing for children on long-term warfarin. METHOD: All patients who had been on point-of-care home monitoring for at least 6 months were included in the study. Their warfarin control was assessed while on home monitoring and compared to that achieved in a similar period before changing from hospital monitoring. RESULTS: Thirty-seven patients were studied for a mean of 1.0 year on clinic monitoring and 1.07 years on home monitoring. The clinic monitoring tests were within a 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 an INR greater than 6.0 with no statistical differences seen between the clinic and home monitoring groups. CONCLUSION: Home point-of-care testing in children on lifelong warfarin is safe, effective and offers a number of advantages to the child and family. Ongoing training and support for the families is essential for this service.
Authors: Javier Caballero-Villarraso; Román Villegas-Portero; Fernando Rodríguez-Cantalejo Journal: Aten Primaria Date: 2010-10-30 Impact factor: 1.137
Authors: Paul Monagle; Anthony K C Chan; Neil A Goldenberg; Rebecca N Ichord; Janna M Journeycake; Ulrike Nowak-Göttl; Sara K Vesely Journal: Chest Date: 2012-02 Impact factor: 9.410
Authors: D B Hawcutt; A A Ghani; L Sutton; A Jorgensen; E Zhang; M Murray; H Michael; I Peart; R L Smyth; M Pirmohamed Journal: Pharmacogenomics J Date: 2014-07-08 Impact factor: 3.550