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Type: Artigo
Title: Home Management Of Inr In The Public Health System: Feasibility Of Self-management Of Oral Anticoagulation And Long-term Performance Of Individual Poc Devices In Determining Inr
Author: Saraiva
Sabrina da Silva; Orsi
Fernanda Andrade; Santos
Marcos Pereira; Machado
Tania; Montalvao
Silmara; Costa-Lima
Carolina; de Paula
Erich Vinicius; Colella
Marina Pereira; Annichino-Bizzacchi
Abstract: The home prothrombin time/international normalized ratio (PT/INR) self-management could be convenient for patients, enhancing treatment compliance and improving the quality of the oral anticoagulation. However, patient self-management (PSM) of oral anticoagulation may not be feasible for up to half of the patients due to cognitive or educational issues. In the present study, we aimed to evaluate the feasibility of a PSM program in a public health medical center that provides care for low-income patients. We also aimed to determine the accuracy of individual point-of-care devices (CoaguChek XSA (R)) during long-term of home manipulation. Patients' time-in-therapeutic range (TTR) and perception of quality of life, were evaluated at scheduled study-visits to the center. Additionally, the accuracy of individual CoaguChek XSA (R) was evaluated in comparison to the standard automated coagulometer at scheduled study-visits to the center. Twenty-five patients were included in the PSM program. The median TTR of patients was 75 % before inclusion, 72 % at 3 months, 75 % at 6 months and 100 % at 12 months after the beginning of self-management (P = 0.14).The median DASS scores were 64, 63, 61.5 and 71.5 before inclusion and at 3, 6 and 12 months, respectively (P = 0.09). One hundred paired INR values were obtained. Correlation between INR values delivered by individual CoaguChek XSA (R) and the automated coagulometer was 94 % and the mean result bias was 0.07 INR units. The coefficient of correlation and the mean bias between methods was stable during 24 months of follow-up. The present study suggests that PSM is feasible for patients treated in the public health system and that the results delivered by CoaguChek XSA (R) have long-term reliability.
Subject: Oral Anticoagulation
Time In Therapeutic Range
Quality Control
Editor: Springer
Rights: fechado
Identifier DOI: 10.1007/s11239-016-1335-6
Date Issue: 2016
Appears in Collections:Unicamp - Artigos e Outros Documentos

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