What is INR self-monitoring?

What is INR self-monitoring?

INR self-monitoring is when a patient takes their own INR reading away from the clinic using a self-testing machine such as a Roche Coagu Chek®.

How can digital health/telehealth improve anticoagulation services?

Patients who have to take anticoagulation medication to optimise their TTR, such as warfarin, often have to visit a clinic regularly for a nurse to take their INR reading. Warfarin patients have to attend clinic to get their INR tested 14 times per year on average.  Nurses may also make home visits to patients in the community to take INR readings. This can apply great pressures on healthcare professionals and can also become a hassle to the daily life of patients.

Alternatively, digital health or telehealth can enable warfarin to be managed remotely, outside of the clinic. Patients can take a sample of blood using a finger prick pen and self-test their INR using a device such as the Roche Coagu Chek®.

Is INR self-monitoring approved by The National Institute of Health and Care Excellence (NICE)?

NICE (DG14) guidance recommends INR self-monitoring for patients with atrial fibrillation (AF) that wish to do so, highlighting the INR self-monitoring service at County Durham and Darlington NHS Foundation Trust as an example.

In a 24 follow up, 70 per cent of patients on the service improved their TTR by 20 per cent compared to in-clinic monitoring, significantly reducing risk of stroke. This was recently support in a major Cochrane review of almost 9,000 patients, where INR self-monitoring halved thromboembolic event incidence.

What is Inhealthcare’s INR self-monitoring service?

Using a Roche Coagu Chek® or a Roche INRange®, patients can test their INR remotely, whether that be from home, work or abroad. This removes the need for patients travel to the warfarin clinic or nurses having to make home visits. Only in the case of an irregular reading exceeding the therapeutic threshold would patients be contacted by a clinician to possibly arrange an appointment or home visit. Our INR self-monitoring service at County Durham and Darlington NHS Foundation Trust reduces average annual clinic attendance from 14 to two.

Can Inhealthcare’s INR self-monitoring service also work for patients who already have their own device?

Yes, if a patient already has their own device, they can still use it as part of the service. They would use an automated telephone call, an email or a smartphone app to relay readings to the clinician as normal.

 

How do patients communicate their INR readings?

Inhealthcare’s INR self-monitoring service enables patients to communicate their INR readings and answer a series of safety questions to clinicians remotely. This can be done via an automated telephone call, SMS, online via a secure web portal or a mobile app.

Importantly our INR self-monitoring service is digitally inclusive, meaning that it can be used by all, regardless of age, technical ability or access to the internet. Our experience has found, while smartphones are widely used, many patients with less confidence in technology prefer the automated telephone calls.

What are the benefits of INR self-monitoring for patients?

INR self-monitoring enables patients to self-monitor their condition with the reassurance that their readings are being closely monitored by clinicians remotely.

Our service has enhanced the lives of patients across the UK including 84 year old John Binks from Wigan who has since increased his self-confidence and improved his clinical outcomes. 59 year old Martin Smith, business owner from North Yorkshire, is now able to travel around the country without worry of missing clinic appointments.

You can find all our patient stories here.

What are the benefits of INR self-monitoring for the NHS?

INR self-monitoring improves patient outcomes, reducing the risk of stroke. It also significantly reduces the number of face to face appointments, increasing clinic capacity and enabling clinicians to more productively spend their time. Our INR self-monitoring service at County Durham and Darlington NHS Foundation Trust alone has saved over 21,000 appointments. Our INR self-monitoring service also reduces the time it takes to dose a patient, and provides a cost effective alternative to DOACs.

What are the benefits of INR self-monitoring for clinical commissioning groups (CCGs)?

INR self-monitoring helps CCGs to manage prescribing budgets as a cost effective alternative to DOACs.

Does the INR self-monitoring service integrate with 4S DAWN and INRStar?

Yes, the INR self-monitoring service integrates with existing decision support software including 4S DAWN and INRStar, meaning the service is fully automated.

Does the INR self-monitoring service integrate with clinical systems?

Yes, the INR self-monitoring service exists with clinical systems including SystmOne and EMIS Web. This means that healthcare professionals can make one click referrals to the INR self-monitoring service, without having to access additional interfaces.

Resources around the INR self-testing service

INR self-monitoring

INR self-monitoring

Find out more about our INR self-monitoring service.

Read more
INR self-monitoring brochure

INR self-monitoring brochure

Download our INR self-monitoring brochure to read what clinicians and patients think.

Download
INR self-monitoring case study: CDDFT

INR self-monitoring case study: CDDFT

Find out how we teamed up with County Durham and Darlington NHS Foundation Trust to deliver our INR self-monitoring service.

Read case study

Want to speak to a member of the team about our INR self-monitoring service?

Please leave your details and a member of our team will be in touch to discuss our INR self-testing service in more detail.

  • Our INR self-monitoring service is live in Wigan, County Durham and Darlington, The Isle of Wight, Ilkley, Berkshire and Hull
  • Our INR self-monitoring service sits on our highly secure national digital health platform, ensuring patient data is safeguarded
  • Our INR self-monitoring service is inclusive of all, offering patients a choice of communication channels
  • Our INR self-monitoring service is ISO 27001 and 9001 accredited and conforms to the highest levels of information governance. Inhealthcare have maintained a score of 100 per cent on the NHS’ IG Toolkit since 2011.

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