Back to Journals » Patient Preference and Adherence » Volume 12

Portable coagulometer for vitamin K-antagonist monitoring: the patients’ point of view

Authors Barcellona D, Mastino D, Marongiu F

Received 5 February 2018

Accepted for publication 16 May 2018

Published 22 August 2018 Volume 2018:12 Pages 1521—1526

DOI https://doi.org/10.2147/PPA.S164680

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 4

Editor who approved publication: Dr Johnny Chen


Doris Barcellona, Diego Mastino, Francesco Marongiu

Department of Medical Science and Public Health, University of Cagliari, Cagliari, Italy

Purpose: The aim of this study was to know the patients’ point of view on the monitoring of vitamin K-antagonist (VKA) therapy by means of a point of care testing (POCT), ie, using a portable coagulometer by self-testing at home. At first, patients had prothrombin time (PT) international normalized ratio (INR) monitoring at a thrombosis center; afterward, they were shifted to self-testing at home. An interview was done to evaluate the patients’ point of view on the two monitoring periods.
Patients and methods: A total of 92 oral anticoagulated patients were enrolled. The questionnaire contained nine questions that elicited a maximum of five closer answers that were arranged in increasing levels of satisfaction: very little, little, enough, much and completely. Percentage of time in therapeutic range (TTR) and adverse events were compared during the two periods of conventional monitoring and self-testing.
Results: The period of conventional monitoring was shorter than that of self-testing (p<0.0001), and the median TTR was satisfactory but lower than that of self-testing (p<0.0001). A total of 85% of the patients were satisfied with self-testing at home. In all, 83% and 73% (p=0.06) of patients felt comfortable about side effects while measuring the PT INR at both home and the thrombosis center, respectively. During the self-testing period, quality of life was improved in 87% of the patients. The cost of test strips was medium–high for 89% of the patients, and 75% of them stated that it was worth improving their quality of life. A switch from VKA to a direct oral anticoagulant (DOAC) was proposed to 24% of the patients, but 68% of them declined because they felt more comfortable monitoring their oral anticoagulant therapy by POCT.
Conclusion: VKA monitoring using POCT at home may play a role in improving the patients’ quality of life and may be considered as an alternative to the use of DOAC at least in certain settings of patients.

Keywords: oral anticoagulants, self-testing, quality of life

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF]  View Full Text [HTML][Machine readable]