Clinical Question: In adult patients on warfarin, does home self-testing of prothrombin time and/or international normalized ratio provide the same outcomes compared to testing by a home health nurse or in a clinical setting?

摘要

Residency Program: University of Oklahoma Health Sciences Center, Department of Family and Preventive Medicine, Oklahoma City, OK. Answer: Yes. Home self-testing for prothrombin time (PT) and/ or international normalized ratio (INR) provides comparable or better outcomes, including similar therapeutic INR levels, decreased thromboembolic events, all-cause mortality and major hemorrhage, when compared to testing in clinical settings. Level of Evidence for the Answer: A Search Terms: home self testing PT/INR, clinical test PT/INR, Coumadin, anticoagulant Date Search was Conducted: September-October, 2013 Inclusion Criteria: adults on anticoagulant for three months or more, long-term Coumadin therapy, thromboembolic events, mortality, major and minor hemorrhage Exclusion Criteria: children on long-term anticoagulants, low intensity (low dose) warfarin therapy vs conventional therapy, patient blogging, cancer patients.