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Health watchdog recommends self-monitoring for warfarin patients

25 September 2014

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Self-monitoring the coagulation status of patients on long-term warfarin treatment will reduce visits to doctors and result in better outcomes according to the National Institute for Health and Care Excellence (NICE).

The new guidance has recommended CoaguCheck XS as a cost-effective way for people to monitor their vitamin K antagonist (warfarin) levels.

Patients on warfarin therapy require frequent monitoring of blood clotting levels (international normalised ratio) in order to spend the longest possible time in therapeutic range (TTR).

The suggested self-monitoring system will reduce clinic visits and lead to better health outcomes as patients increase their time in TTR and reduce their chance of stroke.

A GP in West Yorkshire and member of the NICE Atrial Fibrillation Guideline Development Group, Dr Matthew Fay, said: “The NICE guidance recognises that self-monitoring is accurate and reliable and that warfarin patients prefer the flexibility and reassurance it provides. With the NICE Clinical Guideline on Atrial Fibrillation (AF) published in June recommending that aspirin is no longer used for stroke risk reduction in people with AF, a further 300,000 people will need anticoagulation. Self-monitoring will reduce this increased burden on hospital and clinic resources. Patients taking warfarin should be supported to SelfieChek if it’s right for them and can find out more by speaking to their doctor”.

Just 15% of GPs across the UK offer self-monitoring, with only 11% reporting they have the policy for providing this self-management technique.

Furthermore, merely one third of the 211 Clinical Commissioning Groups (CCGs) support self-monitoring altogether.

The SelfieChek campaign launched by Roche Diagnostics will correspond with the NICE guidance and aim to inform healthcare professionals and patients on the benefits of self-monitoring.

There are nearly one million already people in the UK on long-term warfarin treatment set to benefit from the new NICE publication.

Consultant Stroke Physician at the Royal Devon & Exeter Hospital, Dr Martin James, said: “Improving the quality of anticoagulation control is a key part of stroke prevention in atrial fibrillation, and for many patients self-monitoring represents a practical and convenient – and evidence-based – way of improving their anticoagulant control. The new NICE guidance published today should mean that more people benefit from self-monitoring, and this will help with the implementation of the separate NICE Atrial Fibrillation Clinical Guideline from earlier this year.”

NICE’s Clinical Guideline on Atrial Fibrillation ruled out aspirin as a treatment option for managing this disorder, which means more patients will require anticoagulation treatments (such as warfarin), placing extra pressure on clinics and hospitals

However, the guidance means that more people with atrial fibrillation or a replacement heart valve who are taking warfarin will be able to self-monitor.