INR self-testing
By Georgia Nelson
Blog 17 February 2017

Patients with long-time heart conditions can monitor and manage themselves at home and reduce their chances of having a stroke with an innovative new INR self testing service in East Lancashire.

The technology is for people at risk of stroke (typically with a common condition called atrial fibrillation – an irregular heartbeat) who are prescribed the drug warfarin to prevent blood clotting. People with this condition typically have to attend medical clinics on a regular basis for blood tests to determine their correct dosage.

Under the new service, patients can test themselves at home and send in their results via a bluetooth mobile app, secure web portal or automated telephone call to receive their dosage information which means they can save time attending clinic appointments.

It is part of a stroke prevention programme led by the Innovation Agency, the Academic Health Science Network for the North West Coast. It secured funding to trial the use of innovative technologies to reduce the risk of stroke. Similar testing technologies are being trialled in GP surgeries to improve the monitoring of warfarin.

Patient Yvonne Egan from Blackburn was diagnosed with atrial fibrillation (AF) in 2012. She said: “I think it’s going to be great once I’ve practised it a few times. It will save me the hassle of taking time off work to visit the clinic.”

The father of a teenager with the condition using the self-testing kit said: “Our son developed a rash on holiday and we were worried it was caused by him being on the wrong dose of warfarin. “We spent a whole day in A&E waiting to be seen by medics. If we’d have had the kit then, we could have tested him at home and phoned the clinic to get the correct dose.”

Dr Julia Reynolds, Programme Manager at the Innovation Agency, added: “We are delighted to be working with such an innovative team at the hospitals and supporting their health staff to introduce technologies which help patients.

“Our aim is to prevent strokes and this collaboration will lead to helping better manage atrial fibrillation which is a major cause of stroke.”

Research has shown that self-testing can improve the quality of therapy, reduce the risk of blood clotting and therefore cut risk of stroke.

Inhealthcare is supplying its technology for the service, which is being delivered by staff from the Royal Blackburn Hospital and Burnley General Teaching Hospital.

The service will be rolled out more widely in East Lancashire in the coming months. Anticoagulant clinics will still be the first point of contact for patients if they have any problems or concerns.

“We have rolled out similar services across England, Northern Ireland and Scotland and are looking forward to helping patients and the health service in East Lancashire and Blackburn with Darwen. “In the last 12 months, we have enabled 78,000 digital consultations, connecting patients to clinicians remotely, freeing up much-needed capacity in the NHS.”

Patients are supplied with a handheld device to test their blood’s international normalised ratio (INR) at home. All they need to do is prick their finger using a special pen with a needle and put a drop of blood on a strip which is then inserted into the meter.

Patients are then asked a series of automated health questions as they send their readings to their clinics for analysis either by app or telephone. This yields the correct dosage information and clinicians approve the process before it is sent back to patients.

In East Lancashire and Blackburn with Darwen, around 6,300 people are being treated for AF. A further 2,765 people are estimated to have the condition and are currently untreated because they are unaware they have the condition.

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