Patient self-testing and self-management of oral anti-coagulants with vitamin K antagonists.
Availability of fully automated point of care devices has allowed INR monitoring of vitamin K antagonist therapy to be carried out in the community, rather than in hospital-based clinics and laboratories. Some devices are suitable for use by patients to self-test and self-manage their anticoagulant control. This guideline reviews the evidence for safety, efficacy and cost-effectiveness of patient self-testing (PST) and self-management (PSM), and makes recommendations on training and quality control to ensure PST and PSM are optimised.
This document is a framework service specification for the delivery of anticoagulation services for people with atrial fibrillation (AF).
The specification was developed by Anticoagulation UK in close collaboration with experts in anticoagulation from across primary, community and secondary care. The standards within this framework reflect best practice for services to adhere to, both during and beyond the COVID-19 pandemic.
This project has been fully funded by Bayer plc. The content is independent of and not influenced by Bayer plc who checked the final document for technical accuracy only.
The national roll out of mobile ECG devices by Academic Health Science Networks (AHSNs) was born out of a system-wide procurement initiative to promote the uptake of a digital technology (mobile ECG). This was a novel approach to facilitate innovation adoption which prompted the AHSN Network to commission an independent evaluation of the roll out, at AHSN level, to understand its effectiveness, and in particular what can be learned about: the environments in which the devices are most effective, what characterises an effective implementation package, the impact on the market place, patients (through AF detection) and providers; and the health economic aspects of this type of programme.
Anticoagulant services may not seem to be in the frontline with coronavirus but we do
have a key role in continuing to keep patients on anticoagulants as safe as possible; this
must be planned. In response to pressures on the NHS, the way we deliver
anticoagulants may need to change. We should seek the best local solutions to continue
the safe management of patients on anticoagulation while protecting resources for the
response to coronavirus
A new coalition led by Public Health England (PHE) and NHS England has announced the first ever national ambitions to improve the detection and treatment of atrial fibrillation, high blood pressure and high cholesterol (A-B-C) – the major causes of cardiovascular disease (CVD).
The impact of nonrheumatic atrial fibrillation, hypertension, coronary heart disease, and
cardiac failure on stroke incidence was examined in 5,070 participants in the Framingham
Study after 34 years of follow-up.
