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Home INR testing improves safety for women on warfarin Coumadin® (warfarin) has been prescribed for over 60 years to prevent dangerous blood clots which can lead to heart attack or stroke. Historically, preventative treatment has favored men receiving warfarin over women over fear of falls and bleeding risk in women despite women’s increased risk of heart disease and stroke over men.
Good new for women taking Coumadin® (warfarin) came March 19, 2008 when Medicare announced expanded coverage for patients to test their blood in the privacy of their home. The policy extends benefits to Medicare beneficiaries who have been taking warfarin for at least 90 days for any of the following reasons: atrial fibrillation, mechanical heart valve replacement or venous thromboembolism (DVT/ PE).1
What is home INR testing?
Home INR testing allows patients taking warfarin to test their blood at home with a small finger-stick sample of blood –- not too different for women with diabetes who check their blood for insulin levels. For Coumadin® patients, they simply phone their home test results into their physician through a toll-free number and their results are electronically entered into their chart.
Coumadin® is a medication that requires a small sample of blood to measure the effect of prolonging the bleeding time designed to prevent dangerous blood clot development. Medicare and many private insurance company’s provide reimbursement for up to, but not more frequent, than weekly home testing to reduce bleeding risks.1
Home INR testing however, requires a physician’s prescription for one of the FDA-approved, small, hand-held monitors and for testing supplies. The monitor and testing supplies are not available in retail pharmacies but can be obtained through specialty distributors such as Quality Assured Services, Inc. (QAS). QAS is a Medicare and private insurance provider that distributes, trains and communicates patient’s home test results to the patient’s physicians.
Who is a candidate for home INR testing?
Patients who are motivated, with a desire to improve their control of warfarin and a desire to reduce the risk of side effects, are good candidates for home INR testing. Women taking multiple medications and dietary supplements with or without advanced age make ideal patients to home test their warfarin levels. The test is simple to perform by the patient or a caregiver. Despite 10 years of home testing availability, there remains a bias toward healthcare professionals choosing men for home INR testing despite equal benefit for men and women.
How home INR testing works
Home INR testing enables patients to test more frequently than monthly, in the comfort of their home, resulting in better warfarin control and therefore improved safety.2 Home testing results may be phoned in through a secure 800-number provided through the distributor of the monitor. Testing strips are shipped directly to the patient’s home at no additional charge.
Why test more often?
Weekly testing is a testing frequency that has been proven superior in clinical studies.2 A weekly testing frequency enables accurate evaluation of the effect of patients: diet, overall health, metabolism of Coumadin® and interaction of other medications -– including over the counter products. More frequent testing alerts Coumadin® users of drift or declines sooner than patients who test less often, resulting in keeping patients in their target zone.1
How to get started
Patients or caregivers can have many of their questions answered by visiting home INR testing. Specialty pharmacy providers such as QAS, Inc. provide full-service assistance including insurance and reimbursement questions, clinical and technical support and patient education at no charge to the patient.
While it is always a good idea to present your desire to your physician -- physicians may not be aware home INR testing exists or perceive it will relinquish their control of you or the medication itself. Home testing is complementary to routine professional care and offers additional safety data points between office visits.
Safety is in the hands of the user
For every five fatalities due to stroke, two occur in men and three occur in women. Stroke, while on the decline, remains the 3rd leading cause of death and number one cause of adult disability.3
Warfarin remains the gold standard for the prevention of clot formation leading to stroke however, if poorly controlled, bleeding rates can reach as high as 13% per year.4 Technology now allows women to take greater control of their health through home testing their warfarin levels increasing the benefit of treatment and reducing the risks close to those not on warfarin.
1 Center for Medicare and Medicaid Services. (2008). Decision Memo for Prothrombin Time (INR) Monitor for Home Anticoagulation Management (CAG-00087R) [Memorandum]. Baltimore, MD.
2 Heneghan C., et al. (2006). Self-monitoring of oral anticoagulation: a systematic
review and meta-analysis. Lancet, 367, 404-11.
3 American Heart Association, 2009.
4 Archives Int. Med. 2007.
Add a Comment3 Comments
Typo on my previous message, we ARE now apart of Tapestry Medical and should offer superior service.
January 21, 2010 - 3:21pmThis Comment
I am sorry for your bad experience! We are not apart of Tapestry Medical and look to improve on all our areas of customer service and support. Thank you for sharing you problem.
Gary B Liska
January 21, 2010 - 3:20pmThis Comment
I am 23 and i have a coagu-chek, QAS is pretty horrible but once you get your machine you then can get your supplies cheaper else where. (it took them a whole year to fix my broken machine)
January 21, 2010 - 3:05pmThis Comment