Do cardiologists support self-testing?

If you are on anticoagulation medication, then you are familiar with the time-consuming routine of trekking to the lab to test your INR level, and then, if the results require, scheduling a trip to the doctor to adjust your dosage.

Fortunately, there are new alternatives for people taking anticoagulation medications such as warfarin. Self-testing devices are now available at many pharmacies. These home testing devices provide greater convenience and allow people on warfarin and other anticoagulation medications to become more in tune with changes to their INR levels. But do cardiologists - the experts in the field - think people should use them?

Self-testing may not be the solution for everyone, but doctors agree that it can allow some patients to play a more active, involved role in their care. "The most important factor is an educated, responsible patient who will follow instructions closely," says Dr. C. Russell Mao, Chief Cardiology Fellow at the University of British Columbia.

"They also need to have a good relationship with their physician so that any questions the patient may have will be addressed promptly by the physician," adds Dr. Mao

Self-testing can particularly decrease inconvenience for patients who may need more frequent INR testing. "Any changes in medications or diet change the effects of warfarin," says Dr. Mao. "Therefore, you will need to check your INR more often initially. Also, any disease states such as infections, liver problems, or even high thyroid states can increase the potency of warfarin. Thus the INR needs to be checked more frequently."

Dr. Mao says some patients, such as people with diabetes who are used to testing their blood glucose levels at home, are particularly good candidates for INR self-testing.

"The first step is to talk with your doctor to see if they agree that this is a good option for you and that they will be available to answer any questions you have, including about changes to your warfarin doses according to your INR levels. Prior to starting self-testing, you will also need to be trained on how to use the monitor and how to interpret your results.

"If all of this is in place, then self-testing would be a good option for you."

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