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Anticoagulation, self-monitoring

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https://www.readbyqxmd.com/read/28466601/adult-extracorporeal-membrane-oxygenation-an-international-survey-of-transfusion-and-anticoagulation-techniques
#1
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
#2
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
#3
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
#4
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
#5
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
#6
EDITORIAL
Carl J Heneghan, Elizabeth A Spencer, Kamal R Mahtani
No abstract text is available yet for this article.
February 9, 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
#7
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
#8
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
#9
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
#10
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
#11
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
#12
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
#13
(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
#14
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
#15
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
#16
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
https://www.readbyqxmd.com/read/27384264/control-of-anticoagulation-with-vitamin-k-antagonists-overestimation-of-median-time-in-therapeutic-range-when-assessed-by-linear-interpolation
#17
A M H P van den Besselaar, Joseph S Biedermann, Felix J M van der Meer, Henk J Adriaansen, Frank W G Leebeek, Marieke J H A Kruip
Patients receiving vitamin K-antagonists are monitored by regular assessment of the International Normalized Ratio (INR). There are two popular methods for therapeutic control of anticoagulation in patient groups: 1) Time in Therapeutic Range (TTR) assessed by linear interpolation of successive INR measurements; 2) the cross-sectional proportion (CSP) of all patients' last INRs within range. The purpose of the present study is to compare the two methods using data from 53 Dutch Thrombosis Centres and to develop a semi-quantitative model for TTR based on different types of INR change...
September 27, 2016: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/27378324/self-monitoring-and-self-management-of-oral-anticoagulation
#18
REVIEW
Carl J Heneghan, Josep M Garcia-Alamino, Elizabeth A Spencer, Alison M Ward, Rafael Perera, Clare Bankhead, Pablo Alonso-Coello, David Fitzmaurice, Kamal R Mahtani, Igho J Onakpoya
BACKGROUND: The introduction of point-of-care devices for the management of patients on oral anticoagulation allows self-testing by the patient at home. Patients who self-test can either adjust their medication according to a pre-determined dose-INR (international normalized ratio) schedule (self-management), or they can call a clinic to be told the appropriate dose adjustment (self-monitoring). Increasing evidence suggests self-testing of oral anticoagulant therapy is equal to or better than standard monitoring...
2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27328684/evaluation-of-the-role-and-usefulness-of-a-pharmacist-outpatient-service-for-patients-undergoing-monotherapy-with-oral-anti-cancer-agents
#19
Michio Kimura, Makiko Go, Mina Iwai, Eiseki Usami, Hitomi Teramachi, Tomoaki Yoshimura
INTRODUCTION: When rapid feedback to physicians must be provided, e.g. monitoring therapy with the oral anticoagulant warfarin or providing therapeutic support for patients undergoing cancer chemotherapy, the involvement of pharmacists is required for outpatients. We launched a pharmacist outpatient service for patients with cancer taking oral anti-cancer agents. We evaluated the role and usefulness of the pharmacist outpatient service for these patients undergoing oral monotherapy with anti-cancer agents...
June 20, 2016: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/27325330/budget-impact-of-increasing-market-share-of-patient-self-testing-and-patient-self-management-in-anticoagulation
#20
Jelena Stevanović, Maarten J Postma, Hoa H Le
BACKGROUND: Patient self-testing (PST) and/or patient self-management (PSM) might provide better coagulation care than monitoring at specialized anticoagulation centers. Yet, it remains an underused strategy in the Netherlands. METHODS: Budget-impact analyses of current and new market-share scenarios of PST and/or PSM compared with monitoring at specialized centers were performed for a national cohort of 260,338 patients requiring long-term anticoagulation testing...
June 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
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