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.
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).