Please could anyone give me information, experiences & advice about the availability of PATIENT INR SELF-TESTING / SELF MONITORING ( Coaguchek ) in the Carmarthenshire area of Wales.
My wife has been happily self testing with a Coaguchek machine for many, many years in another UK region. Strips and warfarin supplied via prescription.
With just a six monthly 'machine check' at an NHS clinic.
She is concerned that this facility might not be available in Carmarthenshire and she would have to attend a crowded clinic regularly (like back in the 'olden-days') ?
Am I able to assure her that there is no need for her to worry??
Many thanks
Written by
mrbowtie
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I am not in Wales BUT suggest as a first step you approach your GP's surgery in Carmarthenshire and ask them if they provide this service. If not, then I suggest you do a phone around the various practices in your area of Carmarthenshire and see if you can get this support and if so - then ( if possible/practical) just change surgery to a more progressive one.
Depending, it may be that a surgery does run an INR clinic but will not prescribe test strips.
When I was first put on Warfarin I lived in Surrey and my surgery there ran an INR clinic as part of the surgery services and were totally supportive. They provided test strips on NHS and every 10 tests they provided a means of cross checking the INR readings on my device with their surgery device ...excellent.
When I moved to Cornwall some years later my GP surgery refused to do this and only did testing like " in the olden days" of the dinosaur. Eventually I did a phone around local practices and found one about 4 miles away which provided this service and support and gave me everything my old practice in Surrrey used to do. Brilliant. So I changed surgery.
I was interviewed by a GP ( who was to become my regular GP) so that he could get a grip on how well I understood Warfarin and how well I understood the testing process and I was accepted. Brilliant GP relationship ever since, although it is the INR nurses that I deal with, hardly ever see my GP.
Bore Da mrbowtie, I was interested in your post and live in the Hywel Dda University Health Board area which covers the counties of Carmarthenshire, Ceredigion and Pembrokeshire.
I am a Carer to my husband, who has many complex health conditions and was on Warfarin for many years. Our GP in Newcastle Emlyn monitored his INR regularly, usually done by practice nurses, however changed him to NOAC 2 years ago. I am not aware of any Health Board in Wales that prescribes INR self testing?
To save time you could access the NHS Wales Government website or indeed Hywel Dda University Health Board website, which would provide you with much information including GP services in the area you will be residing in. I trust this is helpful.
sorry. We live in Wales and do not know anywhere that allows self testing. We asked and were told the machine was £300 and you still had to have the results monitored by the surgery.
I've been using my coag meter for three years now that I'm quite confident at adjusting wafarin dose/ I just don't bother with clinics and doctors any more. They only want to see you to get paid a fee for your visit
I'm in North Wales and our GP supplies the strips free of charge for my Coaguchek, no problem. Mind you, they've never done a test on my machine... It's two years old now and I think perhaps I'll make an appointment and drag it round to be checked myself! I suspect it's down to individual GP surgeries as it is in England, so it would be worth talking to the individual practice.
I moved last year from an area that actively encouraged self testing to one where it was not done. I contacted the CCG, told them that I WAS going to continue self testing and sent the the relevant NICE guidelines. I then rang round all the GPs whose area I was in and spoke to the practice managers until I found one willing to let me continue. Granted, its not Wales but I had been told I didn't stand a cat in hells chance, so....... Good luck
I have my own coag metre and I've been using it for about three years with great success. But I did have to pay for it. But the test strips are not very expensive.
I only see the cardiologist about once a year, provided that my INR is within the limits
it's just a question of taking a little bit more or a little bit less WAFFARUN According to your INR
Many thanks for the advice, everyone has been so supportive. much appreciated.
I will follow-up on everything.
It looks like a postcode lottery rather than anything else !!!
With nearly 30 years of warfarin, self testing & experienced use of the Coaguchek machines & dose adjustments etc,, I cannot imagine my wife would ever contemplate attending an old fashioned clinic in this modern age.
If an NHS Wales '21 century solution' cannot be found locally, I suspect going fully 'solo' will be the way forward.
I will update on any progress (or lack of) as time goes by.
Many thanks.
Hi there mrbowtie,
After all these years you will have certainly evolved up the INR ladder, as indeed I have, and would be more than qualified to self test. In your case I too would go fully solo and if it meant buying your own test strips, you might even be able to buy them direct from Roche.
I have now got to the stage where I have two options available to me should the INR go too high or too low. One is to use an INR Algorithm which is available on line or adjust my intake of green leafy veggies. Both work but my preference is to adjust the veggies and not the dose, which is in fact what I do. I am now on 10 weekly test periods, however, I do randomly test more frequently. Following this mantra of veggie change my latest official reading on 26 March 2019 was 2.9.
Personally, in addition to going solo, I would write a letter of formal complaint about your CCG and your surgery to your MP and request that he/she investigate this matter on your behalf. You will get a result.
I had to do this with cataract surgery in 2018 because I was being messed around by my local NHS hospital trust who would not give me a surgery date, even after 7 months of waiting and having had all my pre op assessments - yes sir ! I got results and all of a sudden, mysteriously, I got a date and surgery went ahead.
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