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Anticoagulation - oral - Management
What training and support is needed for people who are self-testing or self-managing?

  • The person must:
    • Give informed consent to self-testing or self-management, including agreement to record results accurately and participate in a quality assurance scheme for the device.
    • Be trained to perform an INR test correctly.
    • If self-testing, understand who to contact with their INR result, and how they will be informed of their new warfarin dose.
    • If self-managing, be trained to adjust the dose of warfarin correctly based on the INR result, using an individualized patient algorithm.
  • Once training has been completed, the person must:
    • Be reviewed at least every 6 months by the responsible clinician.
    • Have access to an appropriately trained healthcare professional for advice when needed (by telephone or in person).
    • Participate in a scheme to check the device is working correctly:
      • Either by participating in a formal external quality assurance programme such as UKNEQAS.
      • Or by regularly attending clinic (such as every 6 months) to take a venous sample for comparison, or to use the clinic point of care device for comparison.
    • Check that each batch of test strips is working correctly.
      • Some strips come with a built-in internal quality assurance facility.
      • For others, the manufacturers supply samples of known INR to be used for quality assurance testing.

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