Skip to main content
construction release_alert
Scholars@Duke will be undergoing maintenance April 11-15. Some features may be unavailable during this time.
cancel
Journal cover image

An evaluation of patient self-testing competency of prothrombin time for managing anticoagulation: pre-randomization results of VA Cooperative Study #481--The Home INR Study (THINRS).

Publication ,  Journal Article
Dolor, RJ; Ruybalid, RL; Uyeda, L; Edson, RG; Phibbs, C; Vertrees, JE; Shih, M-C; Jacobson, AK; Matchar, DB; THINRS Site Investigators,
Published in: J Thromb Thrombolysis
October 2010

Prior studies suggest patient self-testing (PST) of prothrombin time (PT) can improve the quality of anticoagulation (AC) and reduce complications (e.g., bleeding and thromboembolic events). "The Home INR Study" (THINRS) compared AC management with frequent PST using a home monitoring device to high-quality AC management (HQACM) with clinic-based monitoring on major health outcomes. A key clinical and policy question is whether and which patients can successfully use such devices. We report the results of Part 1 of THINRS in which patients and caregivers were evaluated for their ability to perform PST. Study-eligible patients (n = 3643) were trained to use the home monitoring device and evaluated after 2-4 weeks for PST competency. Information about demographics, medical history, warfarin use, medications, plus measures of numeracy, literacy, cognition, dexterity, and satisfaction with AC were collected. Approximately 80% (2931 of 3643) of patients trained on PST demonstrated competency; of these, 8% (238) required caregiver assistance. Testers who were not competent to perform PST had higher numbers of practice attempts, higher cuvette wastage, and were less able to perform a fingerstick or obtain blood for the cuvette in a timely fashion. Factors associated with failure to pass PST training included increased age, previous stroke history, poor cognition, and poor manual dexterity. A majority of patients were able to perform PST. Successful home monitoring of PT with a PST device required adequate levels of cognition and manual dexterity. Training a caregiver modestly increased the proportion of patients who can perform PST.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

J Thromb Thrombolysis

DOI

EISSN

1573-742X

Publication Date

October 2010

Volume

30

Issue

3

Start / End Page

263 / 275

Location

Netherlands

Related Subject Headings

  • Young Adult
  • Warfarin
  • Self Care
  • ROC Curve
  • Prothrombin Time
  • Patient Selection
  • Middle Aged
  • Male
  • International Normalized Ratio
  • Humans
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Dolor, R. J., Ruybalid, R. L., Uyeda, L., Edson, R. G., Phibbs, C., Vertrees, J. E., … THINRS Site Investigators, . (2010). An evaluation of patient self-testing competency of prothrombin time for managing anticoagulation: pre-randomization results of VA Cooperative Study #481--The Home INR Study (THINRS). J Thromb Thrombolysis, 30(3), 263–275. https://doi.org/10.1007/s11239-010-0499-8
Dolor, Rowena J., R Lynne Ruybalid, Lauren Uyeda, Robert G. Edson, Ciaran Phibbs, Julia E. Vertrees, Mei-Chiung Shih, Alan K. Jacobson, David B. Matchar, and David B. THINRS Site Investigators. “An evaluation of patient self-testing competency of prothrombin time for managing anticoagulation: pre-randomization results of VA Cooperative Study #481--The Home INR Study (THINRS).J Thromb Thrombolysis 30, no. 3 (October 2010): 263–75. https://doi.org/10.1007/s11239-010-0499-8.
Dolor, Rowena J., et al. “An evaluation of patient self-testing competency of prothrombin time for managing anticoagulation: pre-randomization results of VA Cooperative Study #481--The Home INR Study (THINRS).J Thromb Thrombolysis, vol. 30, no. 3, Oct. 2010, pp. 263–75. Pubmed, doi:10.1007/s11239-010-0499-8.
Dolor RJ, Ruybalid RL, Uyeda L, Edson RG, Phibbs C, Vertrees JE, Shih M-C, Jacobson AK, Matchar DB, THINRS Site Investigators. An evaluation of patient self-testing competency of prothrombin time for managing anticoagulation: pre-randomization results of VA Cooperative Study #481--The Home INR Study (THINRS). J Thromb Thrombolysis. 2010 Oct;30(3):263–275.
Journal cover image

Published In

J Thromb Thrombolysis

DOI

EISSN

1573-742X

Publication Date

October 2010

Volume

30

Issue

3

Start / End Page

263 / 275

Location

Netherlands

Related Subject Headings

  • Young Adult
  • Warfarin
  • Self Care
  • ROC Curve
  • Prothrombin Time
  • Patient Selection
  • Middle Aged
  • Male
  • International Normalized Ratio
  • Humans