A newly published article that suggests weekly self-testing of INR levels is equal, but not superior to monthly high-quality clinic testing in delaying the time to first stroke, major bleeding episode or death in patients taking warfarin. The result was published in the latest issue of New England Journal of Medicine.
The study, The Home INR Study (THINRS) included 2,922 patients who took warfarin because of mechanical heart valves or atrial fibrillation and who were trained in self-testing of INR. They were randomized to either weekly self-testing at home or monthly high-quality testing in a clinic.
After a follow-up for two to 4.75 years, both groups had similar rates of the primary end point. The self-testing group has more minor bleeding episodes, but was better than the clinic testing group in achieving greater patient satisfaction and maintaining the INR within the target range.
Even though self-testing did not demonstrate superiority in delaying major clinical outcomes, it showed that self-testing of the INR is safe and that self-testing can be recommended to individuals who have limited access to high quality anti-coagulation centers.
Source: N Eng J Med 2010; 363:1608-1620.
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