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Deprecated: Implicit conversion from float 261.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Point-of-Care+Testing+of+International+Normalized+Ratios+for+People+on+Oral++Anticoagulants:+A+Rapid+Qualitative+Review-/-CADTH+Health+Technology+Review 2021 ; ä (ä): ä Nephropedia Template TP
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Point-of-Care Testing of International Normalized Ratios for People on Oral Anticoagulants: A Rapid Qualitative Review #MMPMID34255446
Herington E; MacDougall D
Point-of-Care Testing of International Normalized Ratios for People on Oral Anticoagulants: A Rapid Qualitative Review-/-CADTH Health Technology Review 2021[Mar]; ä (ä): ä PMID34255446show ga
Oral anticoagulants (OACs) are largely taken by people who have a history of blood clots (e.g., deep vein thrombosis, pulmonary embolism) or a condition that increases their risk of developing blood clots in the future (e.g., atrial fibrillation, thrombophilia). The goal of OACs is to prevent the development or increased growth of harmful blood clots without keeping blood from clotting altogether. This can be complicated given the narrow therapeutic range of OACs such as warfarin and because doses often need to be adjusted due to factors such as genetic variation, meals, and the other medications one may be taking. As such, the use of OACs requires ongoing practices of measuring, tracking, and managing how quickly a person's blood clots, which is represented as an international normalized ratio (INR). Along with the people using the OACs, INR management commonly involves multiple other parties, such as primary care providers, laboratories, and pharmacists. In this model, blood must be drawn at a collection centre or medical practice and then sent to a laboratory for testing. The laboratory informs the primary care provider of the INR value who then informs the person taking the OACs and makes dosing adjustments. Point-of-care testing models like community pharmacist-led anticoagulation management services (CPAMS) or self-testing attempt to limit both the time it takes to receive one's INR values and the number of parties involved. The hope is that this not only improves the cost-effectiveness of OAC management, but also improves clinical outcomes given the assumption that this decreases barriers to accessing professional management services. The purpose of this report is to describe how people using OACs and those involved in their care understand and experience point-of-care options in the management of their INR values.