Self Checking INR - Provision of coagucheck strips on prescription

[RobertELee]

I have been initially turned down to receive cogucheck strips on prescription. I know that some (perhaps many) self-checkers do get these items funded. I'm perfectly happy to accept NO when it applies to everyone but not when I happen to fall the wrong side of a postcode boundary. That's discrimination as far as I'm concerned. I don't buy into local finance arguments. If it is deemed that the NHS can afford this then it should be available to all across the country. I'd appreciate an indication of how widespread this problem is and it would be helpful to establish what geographical areas allow/don't allow these things on prescription. Thanks.

[tk11]

Hi leelec, I am in Buckinghamshireand have strips Issued with my repeat prescriptions when required.

Hope this helps, good luck

[dedeottie]

I'm in south Wales and have them on prescription. I also did when I lived in lancashire. However neither areas actively encouraged self testing. Good luck.

[feejbee]

I'm in Berkshire and from my GP it's a definite NO. I am buying my own but Why ? I agree with you it should be all of us or non of us .

Fi

[kernow43]

I'm in Somerset and was dismissed with a curt " we don't do that here " when I enquired at my local surgery.

[Hidden]

Hi leelec,

When I lived in Surrey all nurses in my GP's practice used the coaguchek device. When I bought my own device - which the practice actively encouraged - I got all test strips on NHS.

I moved to Cornwall and although the practice doesn't use this device they know I have one and use it and they still issue the test strips to me on NHS.

Mind you I have twice proved their testing process 'wanting' and my Cornish practice know I am keeping a close check on them.

Cheers

Aussie John

[Dodie117]

I am in London and get mine on NHS. Perhaps this is one of the things afa should campaign for and also make it part of the pathway - that everyone is offered this as an option. Marie

[beano2013]

Re self testing. I self test my INR and strips etc., are provided by my G.P. Practice. I live in Staffordshire area. I think I would be writing a letter to my M.P. Best of luck. Beano 13

[RobertELee]

Thanks to everyone - that's all very useful. Certainly a good number of you are getting the strips on prescription and I certainly intend to stir things up more than a bit at this end (Yorkshire). Some good news, since I wrote the post, is that my local warfarin clinic (local hospital) agree with me and have said they will write to my GP practice on my behalf. I'll let you know how I get on.

[MarkS]

I don't think the availability of strips depends on your local area, but just whether your GP feels like handing them out. I think GPs are taking an illogical and misinformed route if they do not. As usual, a few facts may encourage them change their minds.

Try quoting the results of the STABLE study:

sciencedirect.com/science/a...

Weekly self testing delivers a Time in Therapeutic Range (TTR) of 73.9% in the real world, far better than the typically 60% normally achieved. This leads to a large reduction in stroke risk.

Put a copy of that in front of the GP and ask for his/her justification for continuing to refuse to put the strips on prescription. If he still refuses say you will be considering a complaint to the surgery as you believe that the GP is putting your health at risk. If that does not get you anywhere, complain to NHS England. See:

nhs.uk/choiceintheNHS/Right...

I think you will find that the GP will give in as soon as he sees you have a good case and are determined to see it through.

Mark

[RobertELee in reply to MarkS]

Thank you Mark, very helpful. The problem I have, if I'm entirely honest, is that I actually have a good record of staying in therapeutic range - around 85% since starting on warfarin in February and where I do slip outside, it has always been in the range 3 to 3.5 which, with my CHADS score of 1, is I understand, not too serious.

So why self test? Quite simply, I'm an impatient patient when it comes to INR testing. I too often find the wait for the next blood test unbearable - in case I'm slipping out of range - and so I frequently trot along to the clinic before my yellow book says it's due and only once have I been mildly reprimanded for that. My desire to self test therefore is motivated by a need for reassurance rather than any clinical imperative. Mind you, I suppose some would say my overall well-being is a good enough reason and I guess I need my GP to be thinking along those lines.

[dedeottie]

I completely agree. In my case self assurance is key to my wellbeing and so self testing is a must for me. I would have done it with or without the approval of my doctor but of course everyone is different. If it was my husband he would want to remain in blissful ignorance between test dates for his mental wellbeing. X

[MarkS]

Yes, I agree with both of you. The great thing about the Coaguchek, self testing and self management, is that it puts you in charge of your own medication. I feel really empowered using it. You don't have to rely on anyone else, you just get on and do it. For me the machine is about the best thing I've ever bought, and I would have no hesitation buying the test strips if they weren't on prescription.

Of course some people don't like you taking charge of your own health. That might be partially because they're concerned you might make a mistake or it might be because they like to be in charge, we still have quite a patronising system!

[kernow43 in reply to MarkS]

I've had a moan about this before. I have had a Coaguchek machine for a while now, and my local surgery will not provide the testing strips or recognise my ability to look after my INR myself. I go to the surgery and test when told, but keep myself in range after finding a big difference in readings when they send samples to the path lab. Since they started to use they're own machine to do INR checks, it's been there or there about the same reading as mine, but on two occasions when my sample was sent to the lab for testing recently, there was a considerable difference. The time waiting for collection, transit times and temp must make some difference. Anyway as far as I'm concerned, it's money well spent, and in my experience since being diagnosed with this sodding "condition", the more control I can keep over the prescription of meds, and the possible side effects, the better.