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首页> 外文期刊>Journal of thrombosis and thrombolysis >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
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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

机译：公共卫生系统中INR的家庭管理：口服抗凝剂自我管理的可行性以及单个POC设备在确定INR中的长期性能

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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.
机译：家用凝血酶原时间/国际标准化比率（PT / INR）自我管理可以为患者带来便利，从而提高治疗依从性并提高口服抗凝药的质量。但是，由于认知或教育问题，口服抗凝的患者自我管理（PSM）可能对多达一半的患者不可行。在本研究中，我们旨在评估在为低收入患者提供护理的公共卫生医疗中心实施PSM计划的可行性。我们还旨在确定长期家庭操作期间单个即时护理设备（CoaguChek XSA（R））的准确性。在计划的研究中心就诊时评估了患者的治疗时间范围（TTR）和生活质量感知。此外，与标准自动凝血仪相比，在预定的到中心研究访问时，评估了各个CoaguChek XSA（R）的准确性。 PSM计划包括25名患者。入组前患者的中位TTR为75％，开始三个月时为72％，六个月时为75％，开始自我管理后12个月为100％（P = 0.14）.DASS得分中位数为64、63，纳入前以及分别在3、6和12个月时分别为61.5和71.5（P = 0.09）。获得一百对INR值。各个CoaguChek XSA（R）和自动血凝仪提供的INR值之间的相关性为94％，平均结果偏差为0.07 INR单位。在随访的24个月中，方法之间的相关系数和平均偏倚保持稳定。本研究表明，PSM对于在公共卫生系统中接受治疗的患者是可行的，并且CoaguChek XSA（R）所提供的结果具有长期可靠性。

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