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Home Monitoring of Blood-Thinner Use Appears Effective
Date:10/21/2010

erages around $2,000, according to Dolor, and the supplies for each test cost about $5 to $10. In 2002, Medicare approved coverage for home testing for patients on anticoagulation therapy with prosthetic heart valves, and in 2008, it expanded the availability of home testing to those who need long-term anticoagulation therapy, such as people with the heart condition atrial fibrillation.

In the current study, the researchers randomly assigned 2,922 people who were taking warfarin because they had a mechanical heart valve or had atrial fibrillation to either test weekly at home or monthly in a clinic.

The patients used finger-stick devices approved by the U.S. Food and Drug Administration for home use. They were trained to use the devices, which measure how fast the blood clots, and the results were phoned in to a physician's office to discuss changing the medication dose as needed.

The study volunteers were then followed for between two and 4.75 years, according to the study.

A total of 164,626 home tests were performed, and about 87 percent of the study volunteers adhered to their home testing routine.

Over the study period, 271 people in the home-testing group had a stroke, a major bleeding event or died, compared to 285 in the clinic-tested group. The self-testing group reported significantly more minor bleeding episodes, but it had a small, but statistically significant improvement in the time patients spent in the target range for the medication.

The home-test group also reported slightly higher patient satisfaction scores, according to the study.

Dolor said the researchers didn't design the study to figure out why the home-test group might be more satisfied, but suggested that the convenience of home testing and not having to go out to the doctor's office likely play a role. She said that patients may also feel more in control, and may feel that they have a better understanding of their condition.

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