Patient Self-Testing (PST) allows patients taking warfarin to move a majority of the testing from the clinical setting to the home. PST can provide a more convenient means to perform the INR. However, PST does not eliminate direct contact with the healthcare provider. Patient test results must be reported immediately and office visits are still required to monitor testing and make therapy adjustments.
An ideal candidate for PST would be:
- Under the care of a physician who will prescribe a PST system and monitor the therapy
- Physically capable of performing the test (after training)
- Able to understand and retain the testing procedures
- Willing to follow the provider's recommendations for testing frequency and reporting procedures
- Unable to easily comply with frequent clinic visits because of travel, transportation limitations or other conflicts
- Must be anticoagulated at least 3 months prior to moving to PST
- Reason for taking warfarin must be a long-term indication (at least 12 months)
- INR must be checked once weekly at home
Once approved by the patient's insurance, all monitoring supplies are provided by the service--including the INR monitor, 6 test strips per month and all ancillary supplies needed. The patient is trained in-home and technical support is available. Monthly copay or share-of-cost is generally in the $25-$35 range, though varies by insurer.
Companies currently providing PST services include:
Established patients of the UCSD Anticoagulation Clinic that are selected for PST will be enrolled in the MyChart Anticoagulation Program (MAP) for monitoring.