Self-Monitoring of Blood Thinner May Halve Clot Risk

Wonder how long it will take to get here in the US. I would have loved not to have to specifically go to the clinic to get my blood drawn and recieve those blood bruises from the needle stick.
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People taking the blood-thinning drug warfarin who monitor their own blood and adjust their dosage can reduce the risk of blood clots by half, British researchers report.

Warfarin (Coumadin, Jantoven) is taken to prevent potentially deadly clots in patients with conditions such as atrial fibrillation -- an abnormal heart rhythm -- or a mechanical heart valve. But if the blood is thinned too much, serious bleeding can occur. Keeping the drug in check requires monthly monitoring and frequent doctors visits.

"The concept of self-care and self-monitoring is a growing part of health care it is used widely in diabetes, asthma and hypertension management," said lead researcher Dr. Carl Heneghan, director of the Center for Evidence-Based Medicine at the University of Oxford.

"The evidence shows that self-monitoring is an effective strategy to reduce thromboembolic events in patients taking oral anticoagulants such as warfarin," he added.

Self-monitoring of warfarin, a relatively inexpensive drug, involves using a meter similar to those diabetics use to monitor blood sugar. In this case, patients place a drop of blood from a finger prick on a test strip and insert the strip into the device, which reads what is called the international normalization ratio (INR).

If the INR is too high, risk of bleeding increases; if it is too low, there is an increased risk of stroke. Keeping the INR in the therapeutic range requires monthly checking and sometimes altering the dose of warfarin.

INR monitors cost $1,500 to $2,500, and test strips can run from $7 to $18, according to the National Blood Clot Alliance. Insurance coverage depends on the insurer and for which condition warfarin is taken.

In Germany, as many as 20 percent of those taking warfarin check their own blood and adjust their dosage accordingly, while in the United States only about 1 percent of similar patients do so, the researchers said.

The report appears in the Dec. 1 online edition of The Lancet.

For the study, Heneghan's team culled data from 11 studies that included about 6,400 patients, in a process called meta-analysis, which looks for patterns in previously published studies.

Each study compared self-monitoring with standard care, which involves blood tests done by doctors.

The researchers compared the two approaches in terms of deaths, major bleeding, deep vein thrombosis and stroke in patients with a variety of heart conditions