Many Canadians with a history of clots are taking an anticoagulation medication called warfarin (Coumadin®). This medication helps slow blood clot formation in the body, preventing serious complications from some conditions. However, although warfarin is an effective medication, a person needs to have their blood tested throughout their treatment to ensure the warfarin is being prescribed at the optimal strength. Close monitoring of blood clotting time via blood samples is required to ensure the safety of the person on this medication, as unwanted bleeding or clotting are potential concerns.
Effect of testing on lifestyle
While a person is on warfarin, blood tests are usually ordered by the doctor about every 4 to 6 weeks to check the person's INR (International Normalized Ratio). Most people go to a medical laboratory for this testing, although some attend specialized warfarin clinics in hospitals.
Naturally, time spent testing, waiting for results, and commuting can add up for both patients and their caregivers. Taking time off work is also a problem for busy working people. Employers are not always flexible enough to allow for adjustments based on clinic hours as it increases absenteeism and related cost. Since testing takes place regularly and for the full length of time that a person takes warfarin, this can become quite a chore.
In addition, extended traveling while on this medication may not be possible, as access to laboratories in other countries may be difficult and costly.
Purchasing a portable monitoring device and testing at home is a solution that more and more people are turning to. They may already be self-testing their blood sugar or blood pressure and so are familiar with the flexibility self-testing allows. Or they may simply find that they can't match their schedule to the hours of a lab or clinic.
When patients who performed home blood INR monitoring were asked what they liked about self-testing compared to having their blood drawn at a laboratory, many answered that they found it to be:
- less painful
- more comfortable (i.e. needed less blood)
They also liked the flexibility and control that self-testing gives them.
For individuals on warfarin, self-testing allows them to quickly react to an INR level that is out of range by picking up the phone and informing their physician. Modifications to therapy can be accomplished swiftly.
Thrombosis Canada finds that people who are able to keep their INR value within their optimal range at least 60% of the time significantly decrease their risk of serious complications. Although daily or weekly testing is not necessary for all people taking anticoagulants, it may be recommended by some physicians. People who use a coagulation monitor are more aware of their INR values. Being aware of your INR values through regular testing reduces the risk of serious complications.
Portable coagulation monitors are available in certified pharmacies throughout Canada.
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