Effect of Home Testing of International Normalized Ratio on Clinical Events

Weekly home monitoring of warfarin anticoagulation was not superior to monthly clinic testing in reducing the time to first stroke, major bleeding, or death, but it was associated with improved time within the target INR range, satisfaction with therapy, and quality-of-life scores. Anticoagulation with warfarin, if managed well, is effective in reducing thromboembolic complications such as stroke in patients with atrial fibrillation or a mechanical heart valve. 1 Unfortunately, in clinical practice, warfarin is typically underutilized and the quality of anticoagulation management can be poor, resulting in decreased effectiveness and increased complications. 2 High-quality management, such as that provided by anticoagulation clinics, can be an effective way to improve care but may require that patients travel to a centralized location, limiting the frequency of testing and in some cases access to anticoagulation treatment. Frequent home monitoring of the internationalized normalized ratio (INR) by means . . .