The Pharmaceutical Journal
Vol 270 No 7245 p535
19 April 2003

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Medicines and Healthcare Products Regulatory Agency (www.mhra.gov.uk)

Self-testing of INR may be alternative to attending anticoagulant clinics

Self-testing of international normalised ratio (INR) may be a safe alternative to laboratory testing for patients taking warfarin, researchers conclude.

Dr Hannah Cohen, University College London Hospital, and colleagues are in the middle of conducting a randomised controlled trial in conjunction with the Medicines and Healthcare Products Regulatory Agency to find out whether patients can obtain safe and accurate INR values using CoaguChek S, a hand-held portable meter that gives an INR reading from a finger-prick blood sample within two minutes. So far, 84 patients have been recruited and followed for six months. Dr Cohen presented interim data at a press briefing in London on 11 April. The trial is due to end in August.

Patients in the self-test group tested their INR once a week using CoaguChek S. In addition, they attended a hospital clinic once a month to have a venous blood sample taken for laboratory testing. These results were compared and the authors say that preliminary data show the measurements from laboratory testing and self-testing were "in excellent agreement" with 84 per cent of measurements less than 0.5 INR units apart.

John Hall, director, Dixon & Hall Ltd, uses CoaguChek at the anticoagulant clinics he runs from his community pharmacy. He told The Journal that funding from the local primary care trust only allows a certain number of patients to attend the clinic each year and self-monitoring by some patients would relieve pressure on clinics. However, the need for pharmacist-led anticoagulant clinics will remain. "The majority of patients attending our clinic either have a low disposable income or are elderly and so do not have the manual dexterity to use a portable meter," he said.

CoaguChek S is manufactured by Roche Diagnostics Ltd and can be purchased by patients for £399. CoaguChek testing strips are available on prescription.