Patient barriers and solutions for INR self-testing

Excerpt

Medical technology has improved to allow for more patient empowerment and control of one’s own health care. One such example of this empowerment is in the area of patient INR self-testing. Patient INR self-testing has been shown to improve time in therapeutic range, which can lead to improved clinical outcomes [1‐3]. As promising as this process is for helping to improve the quality of anticoagulation, barriers occur from the patient’s perspective. Results from a survey of 230 anticoagulation clinic providers attending the annual meeting of the Anticoagulation Forum in 2003 were published [4]. Anticoagulation clinic providers identified what they believed were the top three barriers that patients consider for self-testing as the cost of the instrument (86.1%), the cost of the reagent cartridges (72.6%), and lack of knowledge that self-testing is as an option (47.0%). The barrier ranked as number one most frequently by these providers included cost of the instrument (52.6%), lack of knowledge that self-testing is an option (15.2%), and loss of interaction with anticoagulation clinic staff (3.9%). Other problems that can occur with patient self-testing include problems with collection technique, such as not getting a large enough drop of blood, and subsequently wasting strips, as well reliability issues with the patient, including timeliness of getting INR results, failure to report results, and truth of reporting results. …