Is self monitoring inr a possibility?

[mikel46]

recently been diagnosed with multiple bilateral pe. Now on warfarin but as yet not got a correct dose. Travel quite a lot and am concerned about monitoring inr to get levels of 2.5 to 3 suggested by hospital.

Is self monitoring a possibility please?

[Bizzle]

Hi Mike. I feel self monitoring is a good way to go with you travelling quite a lot as I always take my coagucheck machine with me especially as my inr can fluctuate in change of diet. The only problem with a self monitoring machine is getting the test strips from your own GP. Great if your GP is good and will provide a prescription for you but the other option is buying them at approximately £60 a container and using them only when you travel or when you feel the need to check at home in between getting your inr checked at the Surgery can be a godsend and you can make them last about a year, which is the period you can keep them for before needing a new container I think I am right in saying.

[mikel46 in reply to Bizzle]

I will try gp now and see what they say and if they are sympathetic and will prescribe! thanks for comments.

[qbuster in reply to Bizzle]

There is a problem with getting a years supply of strips - the ones I use expire after about a year and my device won't take them if out of date. I have made this point to the Surgery, Pharmacy and device manufacturers (Roche) and made the point that the strips should be available in packs of 6 or no more than 12 (I am given 24 in each pack) - the average user won't get through more than 12 per year.

[nissanjean in reply to qbuster]

Sorry but I strongly disagree.

The regularity of monitoring depends on various factors and can vary from individual to individual.

If self monitoring is not done regularly then what is the point of doing it in the first place?

To suggest requesting fewer test strips defeats the whole objective of self monitoring and those who may have a vested interest in making cutbacks may pick up on what you have written.

As an inpatient the INR is done every day especially if the patient is taking medication that may interact with warfarin.

Each individual comes to know their own body better than anyone else and knows what to do and what not to do to survive.

Diabetics self test several times a day .

This cost is weighed against the cost of unnecessary hospital admissions and also unnecessary/avoidable complications of diabetes.

So why should it people on warfarin be discriminated against?

By self testing we are actually saving the NHS a lot of money.

n.

[brownbear57 in reply to qbuster]

I check my INR every week, so appreciate the testing strips of 24 in each pack.

[nissanjean in reply to brownbear57]

So do I as I am taking medication that is known to interact with warfarin.

[jajaja in reply to qbuster]

I self-test because my INR wanders quite a bit for no apparent reason. Testing a couple of times a week seems about right -- I can go out of range so quickly.

My surgery finds it more cost effective to supply me with strips and stabbers out of their supplies, as opposed to writing a prescription.

[nissanjean]

Yes you can monitor your own INR by buying your own machine.Sometimes the GP will supply the test strips.

If not then you can buy them yourself.

[Balach]

I fought (with the Haematologist) for four years to be allowed to self-test and it was only after my GP intervening that it was agreed. My INR has never been more stable; my GP prescribes the testing strips and he trusts me to self-manage my Warfarin dose. I too travel a lot and the change of diet usually affects my INR - because I self-test this is now not an issue and I feel confident that My INR will almost always be in range.

Iain

[nissanjean in reply to Balach]

I too self test using the machine which I find very accurate.

I was nervous of using it at first but throughout the years I have been using it have found it to be very accurate.

The advantages are obvious.

By the way I am not connected with the Company that manufactures the machine .

I just feel it is the safest most reliable way to manage one's monitoring.

[mikel46 in reply to nissanjean]

Thanks for that!

[mikel46 in reply to Balach]

Will start with my gp and see if he is sympathetic and can agree to self testing and self managing my dose then, many thanks.

[triff]

I've been on Warfarin for nearly three years for a mechanical mitral valve (2.5-3.5) and only just managed to get all the pieces in place to self-test, namely a clinic that'll support it and a GP who'll take me on, isn't crap and will prescribe the strips. I'm still young-ish, I climb/mountain bike/snowboard/injure myself fairly regularly, I have a busy social life, still drink alcohol moderately and travel quite a bit, so aside from all the red tape it was a no-brainer.

In the last week I've got a better grasp of the factors that affect my INR than in the past three years. I missed two doses in a row last weekend (oops...) but was able to test on Tuesday when my kit arrived and self-administer a booster dose which got be back in range two days later. I know this isn't the recommended method but my clinic is crap, when they even do bother answering phone messages it takes up to a week to get an appointment (I have an open PALS complaint against them), so the independence and control I have now is incredible.

So in a word, yes. Find a GP who'll prescribe the strips so you're not wasting £3 every time you get an ERROR 5 and change clinic/hospital if necessary to one that will support you. In my case it meant leaving a clinic I had no problems with at all to one that's borderline negligent, but now everything is in place I can look at switching back.

[mikel46 in reply to triff]

Thanks for the information, its good to hear that it can be done successfully.

[triff in reply to mikel46]

The PALS complaint resulted in my clinic completely changing their working practices, I now email results and get my report/dosage back by email. Couldn't be easier and takes about 5 minutes to test, I even have a 'canned response' in Gmail (it's available in Labs) so I barely need to type anything. They also answer the phone now. \o/

Well, that beats several hours going to the clinic every 2-4 weeks!

How did you get on?

[qbuster]

I've been self-monitoring for about 2 years - it makes life much easier. I paid for the machine myself but I get the test strips on prescription; they are around £2.50 a test and whilst my GP resisted at first, I pointed out that it was cheaper to let me do the test myself as the surgery used the same strips and had the added costs of the nurse's time if the INR was taken there.

On average I test once a month and because I take the kit with with me when I travel I am able to go away on my boat for several months each year.

[nmosese]

Thank you all for the information. I am looking for where I can order the INR machine as my doctor in South Africa r ecommended it due to travelling.

[mikel46]

Roche uk do the machine...see their website and ask for information pack which they sent to me...now got approval to go ahead from consultant and my doctor is sympathetic.