I order my drugs on line and when I go to chemist to pick them up if they include warfarin she always asks what my most recent INR is and what dose I'm on and notes it down. I find this reassuring. Of course if OH picks up my drugs with his she only asks about his INR.
Is this the same for others on warfarin or are we just very lucky?
I think they are supposed to but mine doesn't !! You are lucky!
Never been mentioned to me, just something else I've never heard about until now!
I have to go into my pharmacist with my yellow book, and they photocopy it before they ask the doctor for the prescription, I avoid the surgery whenever possible, hate waiting 3 weeks for an appointment, and even when I get there they know nothing anyway,
That's why I love the online prescription re ordering
WE have a box for repeat prescriptions in the reception area and collect about three days later. from the pharmacy next door. Yes they are supposed to ask and mine usually does unless it is my regular man who knows that I always have the answer and he just raises an eyebrow and I nod. lol
BobD
I pick mine up from boots and they always ask what my last I.N.R. was and when my next test is due. They don't ask to see my book though.
I order my prescriptions on line ( and make appointments on line also, sometimes next day and always within a week). The pharmacy ask to see my yellow book.
Think they should ask but I have never been asked
my surgery has its pharmacy in the next room , and I am always asked by the receptionist who deals with repeat scrips, when my last INR was done and when the next is due, and some times they attach to the repeat pre scrip form a little green form which asks for the same info.
No, I've never been asked by my pharmacy about my INR, I was totally unaware that they should until reading this post.
Hi jean may I ask how long you have been taking meds for , due you not normally get an INR form from your Hospital detailing your test results and doses of anticoagulant.
Yes I get INR results from doctors surgery, get a print out on what doses to take next, if any probs with result the doctor will call and let me know how much to take, but pharmacist has never asked about my INR. Been on meds for almost a year.
Ditto Jeanjeannie's comment.
I attend a weekly anticoagulant clinic and my dose varies on a regular basis . I am on repeat prescription I just request from GP whichever mg I am low on . So GP and pharmacist never check or know my current INR or dose. I am dosed at the anticoagulant clinic.
I order repeat prescriptions online. It works very well. The pharmacist often asks me about my INR.
I'm not sure they need to do that, I think it's down to everyone who takes warfarin to take personal responsibility for their INR.
What would really help is an education programme to go through treating yourself with warfarin - the do's and don't's, plus the Coaguchek should really be free on the NHS (or at least one in every surgery). It would save money in the long run due to the reduction in strokes.
im in the US, my health care is thru Medicare (I'm retired) and Kaiser Permanente, a large non-profit corp. I'm starting coumadin today (after trying Eliquis for a month, wasn't absorbing). Kaiser has an anti-coagulation department handling dosing and monitoring. first blood check will be in 5 days, in the morning so that the anti-coag unit gets the results same day. their self-testing program is available after 3 months of being on coumadin. the program makes you go thru a course of instruction on using the coagucheck machine and the lancets, and then practice using both in front of the instructor. After that, Kaiser loans the patient the coagucheck device and provides the lancets. Co-pays for the labs are relatively high, Coumadin is very cheap.
I as a nurse would love to check my own and have the knowledge and skills to follow a protocol to self medicate thereby freeing up clinical time. However been told this is not possible
I asked my "doctor knows best" GP about getting my own coaguchek. He didn't say no but definitely wasn't keen, saying it wasn't necessary as you could get an INR anywhere and phone him!( I'm a retired nurse) I really have more faith in the surgery computer software than him. It does say on the coaguchek website that you need your doctor to be supportive if you purchase a machine so I'll wait a bit longer!! I don't have a strong case as I live 15 mins walk from the surgery and they do use coaguchek there.
Wendy B
My surgery doesn't do it so I often travel about if needing a check in between my weekly one. Plus I spent 12 hrs one day 2 hrs another day and 6 hrs another day in the Greek Island health system as strongly advised here to have it done on hol. Not as diligent on hol with diet and drink plus different food etc it went up to 8 so needed a bit k drip and re checks. Had I been in control of my own then could have adjusted dose. Well not to worry hopefully removal of my benign cardiac tumours combined with cox maze 1V procedure will cure my AF and I'm time I won't need Warfarin
That's one of my concerns - that the gaps are too long between tests. I tried to explain to GP that on a weeks hol I don't want to spend a morning in a Spanish Hospital and who knows how long trying to get through to him on the phone. Do hope all goes well with surgery - hope you only know enough to be informed -not for you to worry too much. Best Wishes Wendy
My pharmacist doesnt ask - my GP wont put it on repeat with my 4 other meds - I have to ask separately for it. My GP only tests my INR every 10/12 weeks and will not do it inbetween - even if I change meds or have a short course of another med. He has kept me on the same dose since Feb whether the reading is 2.0 or 2.9
Marion
Since my INR has stabilised it will be 6 weeks before I see the Practice nurse again for the next reading. My INR has been checked by the nurse sometimes weekly, but now at longer intervals. The pharmacist has never asked me for my INR reading, or about my Warfarin prescription, but I feel that the situation is being well handled by my GP surgery.
We no longer have a yellow book but a form that comes in the post, we have to take this to our next test but I have copy it other wise I have no record as they keep it. My chemist always ask to see my yellow book even though I keep telling them we do not have one any more!
I've been on Warfarin for 11 years & have never been questioned at pharmacy. ( I have just ordered the Coaguchek outfit )
Sandra
Such a lot of different experiences and systems. They have guidelines for lots of things, why not management of Warfarin. I am guessing that a lot of excellent doctors just don't like being advised on how to manage something. WendyB
I have sample taken at local GP surgery. This is sent to Warfarin clinic at district hospital where it is analysed. Result slip posted back to me and chemist always asks to see this when I collect prescription as it contains dose and next test date info. Bit of a faff really. I asked about self testing but nobody very interested.
As a nurse who worked on cardiac for a while I know enough to worry about op but faith in the staff. My INR over 2 years never been stable enough for other than weekly tests. There is a system for dosing ask whoever doses you to explain less confusing when you know
My pharmacist has never asked in the 13 years I have been on warfarin. She knows I self test since I get the test strips on prescription and only advises me to check INR if I have been prescribed other drugs, like antibiotics, that could interfere with the warfarin. GP doesn't even ask when I re-order, on-line. I self manage and only get an annual check at haematology dept at the hospital. Even then they don't check my INR, just my yellow book. However suits me since I am still actively working around the country. (CoaguChek was the best thing I ever got)
Walter.
Hello everyone, I'm afraid I have not introduced myself to this forum (sorry) but I would like to comment on this subject.
Some areas in the UK allow/promote and finance self-testing of INR. This practice has been recommended for the last 4 years that I am aware of by NICE - who state self-testing is cost effective and much safer for the patient. Personally, I am not in an area of self-testing but because of circumstances where I worked away for weeks on end, there was little or no alternative.
I purchased a CoaguChek XS for £300 (also need to purchase test strips) and it virtually gave me my life back. I no longer had to worry about 'if that meal, or drink' has made my INR too high (the worry continuing until my next appointed INR reading at the hospital) Instead, I could now test my INR myself! At times this could be expensive because if my test was outside of my target range (3- 4) either plus or minus - it would involve taking several readings to establish if my amended dose had brought me back within range. I rarely have to alter my warfarin dose now but I feel happy and confident that should the need arise I can correct my readings and CONFIRM THEM. I do however have to pay for this peace of mind.
Self-reading INR and managing warfarin dose may not be suitable for everyone. Where this is a matter of financial rather than practicable capability, then the facility to self-test should be provided via the N.H.S. bearing in mind the advantages for patient and N.H.S. funding as already supported by NICE.
David
Hello david101
I agree with you. My practice allows self testing and funds the strips. Local policy does not allow self management. Most of the small number here who report their experience of self management achieve 90%+ INR in range, as I did.
I have not seen any evidence that compares outcomes of DOACS vs excellent control of warfarin. My suspicion remains that self managed warfarin is superior to DOACs.
