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Implementation of home-based international normalized ratio testing in adult patients treated with warfarin.

Publication ,  Journal Article
Van Beek, A; Bowers, M; Hall, B; Meyer, B
Published in: Journal of the American Association of Nurse Practitioners
November 2019

Patients who take warfarin require frequent testing of their international normalized ratio (INR) level to ensure accurate dosage. Frequent testing can be inconvenient for patients in rural settings, the workforce, the homebound, or those who travel. Patients who have a home INR monitor can test their blood remotely.To circumvent barriers to INR testing, a quality improvement project was designed to implement home INR testing in an anticoagulation clinic setting.Patients who received a home INR monitor were compared against two usual care testing arms (laboratory and clinic testing patients) in the outcomes of time in therapeutic range (TTR), adverse events, and patient satisfaction using the Duke Anticoagulation Satisfaction Scale (DASS).The DASS survey demonstrated the home testing patients had a statistically significant advantage over the clinic testing group in the subdomain of hassles and burdens (p = .048), as well as the lowest overall scores (indicating highest satisfaction) over the clinic testing group (p = .041). No patients in the home testing group had clotting or bleeding issues necessitating hospital admission. There were no significant differences between groups in the TTR analysis (laboratory 70.8%, home 68.9%, and clinic 64.5%) (p = .683).Home INR testing provides convenience for patients and reduces the hassles and burdens of warfarin management, leading to improved satisfaction. This engagement in self-care translates to reduced adverse events. Home INR testing can be used in warfarin patients who are highly motivated and willing to engage in their care.

Duke Scholars

Published In

Journal of the American Association of Nurse Practitioners

DOI

EISSN

2327-6924

ISSN

2327-6886

Publication Date

November 2019

Volume

33

Issue

7

Start / End Page

563 / 569

Related Subject Headings

  • 4205 Nursing
  • 1110 Nursing
 

Citation

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ICMJE
MLA
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Van Beek, A., Bowers, M., Hall, B., & Meyer, B. (2019). Implementation of home-based international normalized ratio testing in adult patients treated with warfarin. Journal of the American Association of Nurse Practitioners, 33(7), 563–569. https://doi.org/10.1097/jxx.0000000000000339
Van Beek, Andrea, Margaret Bowers, Bruce Hall, and Barry Meyer. “Implementation of home-based international normalized ratio testing in adult patients treated with warfarin.Journal of the American Association of Nurse Practitioners 33, no. 7 (November 2019): 563–69. https://doi.org/10.1097/jxx.0000000000000339.
Van Beek A, Bowers M, Hall B, Meyer B. Implementation of home-based international normalized ratio testing in adult patients treated with warfarin. Journal of the American Association of Nurse Practitioners. 2019 Nov;33(7):563–9.
Van Beek, Andrea, et al. “Implementation of home-based international normalized ratio testing in adult patients treated with warfarin.Journal of the American Association of Nurse Practitioners, vol. 33, no. 7, Nov. 2019, pp. 563–69. Epmc, doi:10.1097/jxx.0000000000000339.
Van Beek A, Bowers M, Hall B, Meyer B. Implementation of home-based international normalized ratio testing in adult patients treated with warfarin. Journal of the American Association of Nurse Practitioners. 2019 Nov;33(7):563–569.
Journal cover image

Published In

Journal of the American Association of Nurse Practitioners

DOI

EISSN

2327-6924

ISSN

2327-6886

Publication Date

November 2019

Volume

33

Issue

7

Start / End Page

563 / 569

Related Subject Headings

  • 4205 Nursing
  • 1110 Nursing