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Anticoagulation, self-monitoring

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https://www.readbyqxmd.com/read/28709455/barriers-and-facilitators-to-reducing-frequent-laboratory-testing-for-patients-who-are-stable-on-warfarin-a-mixed-methods-study-of-de-implementation-in-five-anticoagulation-clinics
#1
Geoffrey D Barnes, Sevan Misirliyan, Scott Kaatz, Elizabeth A Jackson, Brian Haymart, Eva Kline-Rogers, Jay Kozlowski, Gregory Krol, James B Froehlich, Anne Sales
BACKGROUND: Patients on chronic warfarin therapy require regular laboratory monitoring to safely manage warfarin. Recent studies have challenged the need for routine monthly blood draws in the most stable warfarin-treated patients, suggesting the safety of less frequent laboratory testing (up to every 12 weeks). De-implementation efforts aim to reduce the use of low-value clinical practices. To explore barriers and facilitators of a de-implementation effort to reduce the use of frequent laboratory tests for patients with stable warfarin management in nurse/pharmacist-run anticoagulation clinics, we performed a mixed-methods study conducted within a state-wide collaborative quality improvement collaborative...
July 14, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28695382/point-of-care-coagulation-monitoring-first-clinical-experience-using-a-paper-based-lateral-flow-diagnostic%C3%A2-device
#2
Michael A Hegener, Hua Li, Daewoo Han, Andrew J Steckl, Giovanni M Pauletti
Vitamin K antagonists such as warfarin are the most widely used class of oral anticoagulants. Due to a narrow therapeutic window, patients on warfarin require regular monitoring. Self-testing using point-of-care (POC) diagnostic devices is available, but cost makes this monitoring method beyond reach for many. The main objective of this research was to assess the clinical utility of a low-cost, paper-based lateral flow POC diagnostic device developed for anticoagulation monitoring without the need for a separate electronic reader...
September 2017: Biomedical Microdevices
https://www.readbyqxmd.com/read/28671441/self-monitoring-and-self-management-of-oral-anticoagulation
#3
William E Cayley
No abstract text is available yet for this article.
June 1, 2017: American Family Physician
https://www.readbyqxmd.com/read/28667866/a-case-that-illustrates-the-challenges-of-managing-pregnant-patients-with-antithrombin-deficiency-more-questions-than-answers
#4
Leslie Skeith, Andrew Aw, Julia Hews-Girard, Natalia Rydz
Using an illustrative case of a patient with antithrombin (AT) deficiency who developed a recurrent venous thromboembolism (VTE) in pregnancy despite therapeutic low-molecular-weight heparin (LMWH), we highlight what is known in the literature and address areas of controversy through a series of questions around the case. The questions we address include the role of anti-Xa monitoring for patients with past VTE on antepartum LMWH, what treatment regimen is recommended for pregnant patients who develop a recurrent VTE while on therapeutic anticoagulation, the role of antepartum AT concentrate prophylaxis, and the management of labor/delivery, epidural anesthesia and postpartum anticoagulation...
June 24, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28466601/adult-extracorporeal-membrane-oxygenation-an-international-survey-of-transfusion-and-anticoagulation-techniques
#5
S A Esper, I J Welsby, K Subramaniam, W John Wallisch, J H Levy, J H Waters, D J Triulzi, J W A Hayanga, G J Schears
BACKGROUND AND OBJECTIVES: Extracorporeal membrane oxygenation (ECMO) is a method of life support for either isolated cardiac failure or respiratory failure, with or without cardiac failure. When used for hemodynamic support, the ECMO circuit presents a non-endothelialized, artificial surface to blood inciting an inflammatory response which activates haemostatic pathways. Anticoagulation may complicate a pre-existing coagulopathy and/or inadequate surgical hemostasis of varying severity...
May 3, 2017: Vox Sanguinis
https://www.readbyqxmd.com/read/28386037/using-artificial-intelligence-to-reduce-the-risk-of-nonadherence-in-patients-on-anticoagulation-therapy
#6
Daniel L Labovitz, Laura Shafner, Morayma Reyes Gil, Deepti Virmani, Adam Hanina
BACKGROUND AND PURPOSE: This study evaluated the use of an artificial intelligence platform on mobile devices in measuring and increasing medication adherence in stroke patients on anticoagulation therapy. The introduction of direct oral anticoagulants, while reducing the need for monitoring, have also placed pressure on patients to self-manage. Suboptimal adherence goes undetected as routine laboratory tests are not reliable indicators of adherence, placing patients at increased risk of stroke and bleeding...
May 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28378924/educational-and-behavioural-interventions-for-anticoagulant-therapy-in-patients-with-atrial-fibrillation
#7
REVIEW
Danielle E Clarkesmith, Helen M Pattison, Phyo H Khaing, Deirdre A Lane
BACKGROUND: Current guidelines recommend oral anticoagulation therapy for patients with atrial fibrillation (AF) with one or more risk factors for stroke; however, anticoagulation control (time in therapeutic range (TTR)) with vitamin K antagonists (VKAs) is dependent on many factors. Educational and behavioural interventions may impact patients' ability to maintain their international normalised ratio (INR) control. This is an updated version of the original review first published in 2013...
April 5, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28353255/development-of-a-user-friendly-app-for-testing-blood-coagulation-status-in-schizophrenia-patients
#8
Johannes Vegt, Paul C Guest
Blood coagulation time is an important factor to consider for postoperative and cardiac disorder patients who have been prescribed anticoagulant coagulant medications. The coagulation process is also known to be perturbed in some individuals with psychiatric disorders, such as schizophrenia. This chapter describes a patient self-management system for a functional assessment of blood coagulation activity, determining the appropriate anticoagulant dosages using a test strip device and the Coagu app. The app can also be used as a patient reminder of treatment times and to monitor treatment and effects over time...
2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/28302116/portals-design-of-an-innovative-approach-to-anticoagulation-management-through-ehealth
#9
E P W A Talboom-Kamp, N A Verdijk, I J S H Talboom, L M Harmans, M E Numans, N H Chavannes
BACKGROUND: For the monitoring of International Normalized Ratio (INR) values, venous thromboembolism (VTE) and atrial fibrillation (AF) patients can visit anticoagulation clinics, laboratories, or physicians for venous puncture. Point-of-care testing (POCT) made it possible for patients to monitor INR themselves (self-monitoring) and even self-adjust their medication dosage (self-dosage). Both skills are accepted as forms of self-management. eHealth applications can improve this self-management, resulting in better clinical outcomes...
March 16, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28183792/cochrane-corner-self-monitoring-and-self-management-of-oral-anticoagulation
#10
EDITORIAL
Carl J Heneghan, Elizabeth A Spencer, Kamal R Mahtani
No abstract text is available yet for this article.
June 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28011812/impact-of-self-funding-on-patient-experience-of-oral-anticoagulation-self-monitoring-a-qualitative-study
#11
Alice Tompson, Carl Heneghan, Stephen Sutton, David Fitzmaurice, Alison Ward
OBJECTIVE: To explore the impact self-funding has on patient experience of oral anticoagulation therapy self-monitoring. DESIGN: Semistructured, qualitative interviews were conducted. Transcripts were analysed thematically using constant comparison. SETTING: England. PARTICIPANTS: Interviewees were participants of the Cohort Study of Anticoagulation Self-Monitoring (CASM). Cohort members were recruited as they bought a monitor from the major manufacturer in the UK...
December 23, 2016: BMJ Open
https://www.readbyqxmd.com/read/27896780/development-of-a-user-friendly-app-for-assisting-anticoagulation-treatment
#12
Johannes Vegt
Blood coagulation time is an important factor to consider for postoperative and cardiac disorder patients who have been prescribed anticoagulant coagulant medications. This chapter describes a patient self-management system for assessment of blood coagulation times and determining appropriate anticoagulant dosages using a test strip device and the Coagu app. This app can also be used as a patient reminder of treatment times and to monitor treatment and effects over time.
2017: Methods in Molecular Biology
https://www.readbyqxmd.com/read/27888189/patients-who-self-monitor-or-self-manage-can-improve-the-quality-of-their-oral-anticoagulation-therapy
#13
Michelle Kennedy
No abstract text is available yet for this article.
January 2017: Evidence-based Nursing
https://www.readbyqxmd.com/read/27785043/international-normalized-ratio-self-testing-and-self-management-improving-patient-outcomes
#14
REVIEW
Matteo Pozzi, Julia Mitchell, Anna Maria Henaine, Najib Hanna, Ola Safi, Roland Henaine
Long term oral anti-coagulation with vitamin K antagonists is a risk factor of hemorrhagic or thromebomlic complications. Periodic laboratory testing of international normalized ratio (INR) and a subsequent dose adjustment are therefore mandatory. The use of home testing devices to measure INR has been suggested as a potential way to improve the comfort and compliance of the patients and their families, the frequency of monitoring and, finally, the management and safety of long-term oral anticoagulation. In pediatric patients, increased doses to obtain and maintain the therapeutic target INR, more frequent adjustments and INR testing, multiple medication, inconstant nutritional intake, difficult venepunctures, and the need to go to the laboratory for testing (interruption of school and parents' work attendance) highlight those difficulties...
2016: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/27754958/point-of-care-testing-inr-an-overview
#15
REVIEW
Doris Barcellona, Lara Fenu, Francesco Marongiu
Oral anticoagulant therapies with the anti-vitamin K drugs (AVK), warfarin, acenocoumarol and phenprocoumon, are employed in primary and secondary anti-thrombotic prophylaxis in patients with venous thromboembolism, atrial fibrillation and cardiac mechanical valves. However, a monitoring test such as the International Normalized Ratio (INR) is required. The periodic monitoring of this therapy entails discomfort for the patients. Telemedicine and telecare can provide significant aid in the management of this therapy allowing patients to perform the test at home or anywhere else with a portable device, i...
May 1, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/27740916/can-pharmacogenetics-help-patients-under-chronic-treatment-with-coumarin-anticoagulants
#16
Isabel López, Estela Sangüesa, Yves Vancraenendonck, Estefanía Zuriaga, María Pilar Ribate, Cristina Belén García
Vitamin K antagonists are highly effective antithrombotic drugs. However, appropriate dosing is difficult to establish owing to its narrow therapeutic window as well as widespread inter- and intra-individual variability in dosage. Compared with dosing solely based on clinical information, pharmacogenetics can help improve the therapy with coumarins by decreasing the time to reach a stable dose and reducing the risk of bleeding. Most of the studies about genotyping of patients using vitamin K antagonists have focused on predicting the stable dose...
December 1, 2016: Drug Metabolism and Personalized Therapy
https://www.readbyqxmd.com/read/27694107/dtb-select-10-october-2016
#17
(no author information available yet)
Updated competency framework for all prescribers ● The risks of under-prescribing in older patients ● Self-monitoring and self-management of oral anticoagulation ● Role of sunscreen in preventing basal cell and squamous cell skin cancers ● Tech-based weight-loss intervention ● NICE guidance on NAFLD ● Modest improvement in sinus symptoms with nasal irrigation ● Exercise to offset the detrimental effects of sedentary habits.
October 2016: Drug and Therapeutics Bulletin
https://www.readbyqxmd.com/read/27686643/-the-application-effect-of-traditional-monitoring-and-self-monitoring-methods-in-oral-anticoagulant-patients-with-mechanical-valve-replacement-patients-a-meta-analysis
#18
Y C Zhang, Y T Li, Y F Fan, Q Fang, H Y Fu, G H Xie, K Hu
Objective: To evaluate the effects of traditional monitoring and self-monitoring in patients who take the oral anticoagulation medicine after mechanical valve replacement surgical operations. Methods: A great number of Chinese and English literatures about this subject were investigated in detail, and these literatures were selected from the Cochrane Central Register of Controlled Trials, EMBase, MEDLINE, Web of Knowledge, CNKI, CBM, VIP, and WanFang Data. It should be noted that all of the literatures were published before October, 2015...
October 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/27624485/oral-anticoagulation-with-vitamin-k-inhibitors-and-determinants-of-successful-self-management-in-primary-care
#19
RANDOMIZED CONTROLLED TRIAL
E Tamayo Aguirre, A Galo-Anza, O Dorronsoro-Barandiaran, E Uranga-Saez Del Burgo, A Ostiza Irigoyen, A Garcia-Carro, I Lopez-Fernandez, N Colera, P Saez-Garbayo, I Tamayo-Uria
BACKGROUND: Self-management may be an option to monitor oral anticoagulant therapy in health systems, but before recommending it, we need to assess patients' ability to take on this task. The purpose of the study was to describe patients' ability to self-manage and associated factors. METHODS: This was a 3-year prospective quasi-experimental study with a control group. Overall, 333 patients on anticoagulant therapy from seven primary care health centres of the Basque Health Service were included in the intervention group and followed up for 6 months after the intervention, assessing their ability to self-test and self-manage...
September 13, 2016: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/27468696/predictors-of-anticoagulation-quality-in-15%C3%A2-834-patients-performing-patient-self-management-of-oral-anticoagulation-with-vitamin-k-antagonists-in-real-life-practice-a-survey-of-the-international-self-monitoring-association-of-orally-anticoagulated-patients
#20
Christian Schaefer, Walter A Wuillemin, Alfons Kessels, Alan Jacobson, Michael Nagler
Although patient self-management (PSM) of oral anticoagulation with vitamin K antagonists is recommended for patients requiring long-term anticoagulation, important aspects are still unclear. Using data from a large international survey (n = 15 834; median age 72 years; 30·1% female), we studied predictors of poor anticoagulation control (percentage of International Normalized Ratio values within therapeutic range below 75%) and developed a simple prediction model. The following variables were identified as risk factors for poor anticoagulation control and included in the final model: higher intensity of therapeutic range (odds ratio [OR] on every level 1·9; 95% confidence interval [CI] 1·8-2·0), long intervals between measurements (>14 d; 1·5; 95% CI 1·3-1·7), female sex (OR 1·3; 95% CI 1·2-1·4), and management other than PSM (OR 1·4; 95% CI 1·2-1·6)...
November 2016: British Journal of Haematology
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