Home INR Monitoring Testing Frequency
Home INR Monitoring enables consistent testing between regularly scheduled office visits.
Since warfarin (Coumadin® medication) therapy has a narrow therapeutic range, it must be closely managed. Adherence and compliance with Home INR Monitoring provides the potential for you to realize the full benefits, as seen in clinical trials.
Patient INR self-testing is clinically proven to increase time in therapeutic range by enabling consistent testing. Testing INR weekly results in fewer INR amplitudes, which are commonly associated with adverse events.1, 2
The Self-Testing Analysis Based on Long-Term Experience (STABLE) study1, the largest study ever conducted, found that weekly patient self-testing provided the greatest safety for patients taking warfarin:
- Weekly home testing demonstrated a 47% reduction in risk of major bleeding event or stroke.
- Weekly testing provided optimal control at 74% time in target range (TTR).
- Surpassed previous benchmark controlled trials TTR by 8% (THINRS3, Bloomfield 22-study meta-analysis4).
CMS Decision and Coverage
Medicare has recognized the importance of the weekly testing for patient safety and they provide coverage within the following guidelines5:
Provision of test materials and equipment for home INR Monitoring of patient with either mechanical heart valve(s), chronic atrial fibrillation, or venous thromboembolism who meets Medicare coverage criteria; includes: provision of materials for use in the home and reporting of test results to physician; testing not occurring more frequently than once a week; testing materials, billing units of service include 4 tests.
Clinically Relevant Results
Home INR Monitoring provides clinically relevant INR tests between routine clinician visits, providing a higher level of INR control and quality of care for your patients. And since maintaining the proper INR level can be difficult for many people, consistent weekly testing is recommended for patient safety and it allows you to adjust medication dosage sooner, if needed.
Reporting results from home testing patients can be setup to be direct to Alere or direct to your office. If patients report directly to Alere, either live or into our secure database management system, we can:
- Alert you only when a patient is out-of-range (Management by Exception)
- Send you all patient test results on the schedule you choose
- Offer options to access patient results electronically
- Ansell, J. March 2012. Patient Self-Testing: Real-World Experience Within a Comprehensive Support Service Represents a New Standard of Care, Attaining High Quality Anticoagulation Control. Poster presented at: American College of Cardiology.
- Heneghan C, et al. Self-monitoring of oral anticoagulation: a systematic review and meta-analysis. Lancet. 2006; 367:404-11.
- Matchar DB, Jacobson A, Dolor R, et al. Effect of home testing of international normalized ratio on clinical events. N Engl J Med 2010; 363:1608-1620.
- Bloomfield H.E., et al. Meta-analysis: Effect of Patient Self-testing and Self-management of Long-term anticoagulation on major clinical Outcomes. Ann Intern Med 2011; 154, No. 7: 472-482.
- Center for Medicare and Medicaid Services. Decision Memo for Prothrombin Time (INR) Monitor for Home Anticoagulation Management (CAG-00087C) [Memorandum]. 2001. Baltimore, MD.
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