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Commentary on: Grogan A, Coughlan M, Prizeman G, et al. The patients’ perspective of international normalized ratio self-testing, remote communication of test results and confidence to move to self-management. J Clin Nurs 2017. doi: 10.1111/jocn.13767. [Epub ahead of print: 23 Feb 2017].
Implications for practice and research
Patient self-testing and self-management programmes that augment education and telehealth approaches present a safe, sustainable and acceptable model of care for individuals with routine anticoagulation monitoring and management needs.
There is need for further research of patient self-testing and self-management programmes that addresses patient selection and building patient confidence.
Warfarin remains a key agent for thromboprophylaxis. However, it is not without complications. A narrow therapeutic range translates to a fine balance between thrombosis and bleeding. Given warfarin’s sometimes unpredictable nature, achieving quality anticoagulation can be challenging. Regular monitoring and careful titration of therapy are required in accordance with a patient’s international normalised ratio (INR). For the majority of patients, this means visits for regular venous blood sampling which can be costly, inconvenient and impact on a patient’s quality of life. Evidence suggests that patient …
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Competing interests CF is a Board Director of the Australasian Cardiovascular Nursing College and an Executive Member of the Cardiovascular Nursing Council of the Cardiac Society of Australia and New Zealand. He is the nursing co-lead on the Stroke Foundation (Australia) (2017) Guideline Update and a member of the Heart Foundation (Australia) Atrial Fibrillation Management Guidelines Writing Working Group. He is a member of the Stroke Foundation (Australia) Research Advisory Committee and an Ambassador of the Stroke Foundation. He has received funding from the Stroke Foundation and honoraria from Pfizer for teaching. He is a member of the Editorial Board of the Journal of Clinical Nursing.
Provenance and peer review Commissioned; internally peer reviewed.