Is the GP computer dosing accurate?

I used to self manage before getting pregnant but since I've had my baby I've been getting my inr checked at my gp as it has been a bit up and down. They use a computer to dose me but I don't have much faith in it and often end up dosing myself anyway. For example today my inr was 1.8 but it has said to stay on the same dose until next Wednesday and then up it one mg then test again Thursday. This seems inaccurate to me as I would have increased my dose tonight as my inr will now be low until at least next week? The nurses doing the dosing don't seem to know anything about it so wondered what research has actually gone into this dosing system and if anyone else has problems? Thanks.

5 Replies

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  • What is your target INR? If you are only at 1.8 with say a target of 3.00 then leaving it till next week before an increase is clearly wrong. Also increasing on Wednesday and then testing Thursday would also not be correct as it usually takes 48 hours for a change in dose to work its way through.

    You are correct they clearly don't know what they are doing. Can you not ask to be transferred to your nearest anticoagulation Clinic for testing? If not I suggest you speak with your GP and tell him/her whats going on and explain that the service you are getting is not good enough and could actually be dangerous.

  • Warfarin actually takes up to 5 days to reach therapeutic effect, which is why INR tests are repeated in weekly blocks until stable* Warfarin management is likened to steering a large ship, you have to think far ahead.

  • If you were self managing before why not carry on? You seem to have more knowledge than your GP. I feel much safer self testing and being in control. I have the support of a Consultant at the Hospital who understands Hughes Syndrome. Is there anyone at your Hospital or Warfarin Clinic that could support you?

  • Dosing software is fairly routine in GP practice's these days and many are created by Drs for Drs. INRStar, Dawn, Etc are the more common decision support software programs. The clue is in the title though, they're for support. If you've self managed your own dosing successfully and have achieved good time in therapy range, why not carry on with GP support?

  • Sorry I only just read these replies. This is now my only anti coagulation clinic as used to be at the hospital but the haematologist that did it left and they cancelled the service. It's now only done through the gp clinic. I mentioned my concerns to the nurses and they just sort of said' oh 'and that was that. One of them mentioned to my doctor before that I was sometimes dosing myself and all he said was let her do what she wants she knows more than us! So basically I feel completely alone with it all. I used to self manage with my haematologist but I don't even have one now. I'm just glad I have the sense to know its wrong.

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