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What Doctors Say About PT/INR Patient Self-Testing at Home

In addition, the American College of Cardiology, the American Academy of Neurology, and the Society of Thoracic Surgeons have each written to CMS advocating for patient self-testing.

I believe self-testing will decrease the complication rates and overall cost of managing patients on Coumadin following mechanical valve implants in a statistically significant manner... I believe that PST will similarly improve patient quality of life, measurable by standard QOL questionnaires.

- Todd K. Rosengart, M.D., Evanston Illinois  Head of Cardiothoracic Surgery and Co-Director of the Cardiovascular Care Center, Evanston Northwestern Healthcare Associate Professor of Surgery, Northwestern University Medical School


For the patient who can follow the physician's direction, the self testing...will most definitely allow more accurate monitoring of the INR and maintain patients in the desirable range of 2.0 to 2.5.  It follows that since this range has been shown to reduce events of bleeding and thromboembolism, the quality of patients' lives will be positively influenced by their not having major complications.

- Roy G. Masters, M.D., Ottawa, Canada  Professor of Surgery, University of Ottawa Heart Institute Residency Program Director in Cardiac Surgery, University of Ottawa


We suggest that [our study's] results support that home INR testing is an acceptable alternative to high-quality anticoagulation management, such as in an anticoagulation clinic, and it may be preferable when patient access is difficult, such as might occur with patients with disabilities or [patients who live at a] geographic distance.

- Dr. David B Matchar, Duke Center for Clinical Health Policy Research, Durham, NC


We were impressed by the high proportion of patients who were able to competently demonstrate the ability to utilize PST either on their own or with the assistance of caregivers. These results support that home testing is an acceptable alternative to high-quality clinic care and may be preferable in those cases where patient access is difficult due to disability, distance, or other limitations.

- Dr. Alan K Jacobson, Loma Linda University School of Medicine, CA


Involving my patients with the simple finger-stick test empowers them to better manage their Coumadin levels. The studies show that self-testing on a weekly basis clearly 'works' to reduce the time out of range and reduce the complications of bleeding or clotting associated with anticoagulation therapy.

- Irvin B. Krukenkamp, M.D., Former Chief of Cardiothoracic Surgery and Director of the Heart Center, SUNY Stony Brook, New York


Home testing is a win-win situation for [patients on daily anti-coagulation therapy] because now they have some ability to understand their medication, take some control in how they’re treated to minimize the complications of anticoagulation and I believe that gives them a good sense of well being.

- Richard J. Shemin, M.D., Chief of the Division of Cardiothoracic Surgery, UCLA Medical Center



Self testing has proven itself to be invaluable in my practice by detecting early the rapid changes in the INR when my patient is put on an antibiotic or other drug.

- Joseph B. Sappington, M.D., F.A.C.C., Board-Certified Interventional Cardiologist, St. Francis Hospital, Hartford, Connecticut


We refer patients for self-monitoring when we’ve established that they need more independence than what they’re getting from us. That seems to be growing as the indications for anticoagulation grow. We receive reports an hour after the patient self tests, so we never worry that we’re missing something or that the patient is in any danger of any kind.

- Maureen Howard, APRN, BC, Program Manager, Anticoagulation Center, Staten Island University Hospital, New York


Home testing is so much better for patients.  As an emergency department physician, I see the complications of INR that are too high or too low, and many of these complications are so unnecessary.  The availability of self-testing improves patient care and the patient's margin of safety.

- Joanne Edney, M.D., Director of Emergency Department, Colorado