Empowering Patients to Monitor and Manage Oral Anticoagulation Therapy
- Jack E. Ansell, MD
- Author Affiliation: Department of Medicine, Boston University Medical Center, Boston, Mass.
Since this article does not have an abstract, we have provided the first 150 words of the full text.
- KEYWORDS:
- anticoagulants
- international normalized ratio
- patient education
- patient satisfaction
- self-care
Oral anticoagulation management has undergone a number of improvements since the discovery and first clinical use of dicumarol in the early 1940s. In this issue of THE JOURNAL, Sawicki1 describes a model of anticoagulation management that introduces the next phase in this evolution, a model of patient self-management made possible by point-of-care PT monitoring.
Since the introduction of point-of-care PT instruments more than 10 years ago,2 a number of instruments have become available or are in development that determine a PT-INR measurement equivalent by activating capillary whole blood with tissue thromboplastin. The end point of clotting is determined by assessing the movement of blood cells or oscillating iron particles or by assessing the generation of thrombin by a fluorescent probe. Instruments are small, lightweight and portable, and studies have confirmed that patients can easily and accurately perform a fingerstick and obtain a PT-INR measurement from a sample of …
