We motivate patients to take control of their own oral anticoagulation therapy
More than 4.000.000 patients in Europe are living on long-term oral anticoagulation.
The target of the International Self-Monitoring Association of oral Anticoagulated Patients (ISMAAP) is to offer patients a better understanding what coagulation means.
How to live with anticoagulants. What kind of risks exists and also the benefit for anticoagulated patients.
On the other hand we are looking for a better cooperation between patients and physicians.
Physicians should understand the problems and worries of the patients when patients have to on long-time anticoagulation. Here we need a better way of communication.
In the name of the authors, we would like to thank you for taking interest in these subjects. Managing Board of the ISMAAP, Geneva.
"Active, informed patients are natural partner in managing anticoagulation therapy efficiently"
Anticoagulation - Patient Self-Management
Living with anticoagulants
We invite you to a journey between Scylla and Charybdis (please click on the picture below).
Frequent monitoring of Atrial Fibrillation patients key to optimal outcomes when treated with anticoagulants
Latest opinion confirms overwhelming evidence of the benefits of risk-adjusted
oral anticoagulation on stroke reduction in patients with atrial fibrillation
Self-monitoring and self-management of oral anticoagulation
The introduction of portable monitors (point-of-care devices) for the management of patients on oral anticoagulation allows self-testing by the patient at home. Patients who self-test can either adjust their medication according to a pre-determined dose-INR schedule (self-management) or they can call a clinic to be told the appropriate dose adjustment (self-monitoring). Several trials of self-monitoring of oral anticoagulant therapy suggest this may be equal to or better than standard monitoring.
Josep M Garcia-Alamino, Alison M Ward, Pablo Alonso-Coello, Rafael Perera, Clare Bankhead, David Fitzmaurice, Carl J Heneghan (2010)
Read more:
http://www.cochranejournalclub.com/self-monitoring-and-self-management-oral-anticoagulation-clinical/
Will Genetic Testing help?
For patients taking warfarin (Coumadin®) the only Vitamin K antagonist (VKAs) available in the US, keeping within ones INR range lessens the chance of an adverse reaction (bleeding) and increases the VKAs prevention of dangerous blood clots.
Sometimes technology can really change your life for the better.
Self-testing my INR on my portable monitor is one of those technologies. In 1992 I was in heart failure because my mitral valve fell apart (Myxomatous degeneration). I was short of breadth, couldn't walk and had to rest after speaking a few words. My valve was replaced with a St. Jude Valve on February 8th, 1993. I was back at work in 4 months at Columbia University in New York as a physician at the student health service. I am on lifetime warfarin to prevent blood clots in my reengineered heart. I was thrilled to be alive but dependant on monthly lab visits and having to hustle to find labs when we traveled.
Recently I decided to put together a video showing me doing my weekly INR test. I'm sure this is familiar to the many ISMAAP patients and visitors to the website. Here is a link to our YouTube video "Coumadin (the brand name of warfarin) Self-Testing Monitor". It is in real time and is 3:36 minutes long: http://www.youtube.com/watch?v=mT2bc9Q_wDc
Michael, Feb. 4th, 2010
Home monitoring of INR using point-of-care testing is a viable option for patient involvement.
In 1998 I read about INR monitors to help me regulate my warfarin dose. Warfarin (Coumadin) is the only vitamin K antagonist (VKA) available in the US. I attempted to obtain one through my health insurance company. It took two years and many letters from my Cardiologist to get my first monitor. Since that time most US insurance plans have reviewed the research data and have agreed to reimburse the cost of Monitors and supplies (test strips etc.). In March 2008 the largest Health Insurer (Medicare) began covering Monitors. As of April 2010 there are approximately 65,000 Americans who do self testing of the approximately 4 million Americans who take warfarin (1.6%). This is up from an estimated 50,000 in April of 2009. In some European Countries 25-50% of suitable patients on warfarin do self testing and self management. In the US our health care system pits hospitals that want to fill beds against insurers that want to minimize reimbursement. In most European Countries health care providers and insurers are one and the same therefore reducing hospital admissions benefits and controls costs. Also in the US Insurance Companies pay health care clinicians very little to review weekly results for those patients who self-test. It is advantageous for providers to have patients come in for monthly INR testing.
Patients with artificial heart valves:
Less “out-of-range” INR values under low dose
Background
INR self-management after mechanical heart valve replacement resulted in a higher compliance of therapy. INR self-management with low dose anticoagulation reduces the risk for thromboembolic events without increasing the risk of bleeding. The aim of the present study is to investigate the effects of a very low target range of INR value and to predefine a target value with more reduced complication rates.
News on anticoagulation management
From October 1-3, 2009, the 5th International Patient & Physician Conference on Anticoagulant Therapy took place in Brussels, Belgium. The event was organized by the International Self-Monitoring Association for oral Anticoagulated Patients (ISMAAP) and the International Self-Monitoring Association for oral Anticoagulation (ISMAA). On Friday October 2, the plenary lectures, which brought together medical experts and patient organizations, cast new light on some of the hot topics of life with anticoagulation therapy.
Anticoagulation therapy in the elderly patient
Rebecca J. Beyth, MD, MSc, Associate Professor, University of Florida at Gainesville
INR self-management in the elderly
Scott S. Kaatz, DO, MSc, FACP, Clinical Associate Professor of Medicine, Director Anticoagulation Clinics, Henry Ford Hospital, Detroit
Pregnancy under anticoagulation therapy – a high risk?
Hannelore Rott, MD, MVZ-Lab, Duisburg, Germany
Pregnancy under anticoagulation therapy – a high risk? (II)
Heinrich Koertke, MD, Bad Oeynhausen,Germany
Anticoagulation management modalities and quality of life
Scott S. Kaatz, DO, MSc, FACP, Clinical Associate Professor of Medicine, Director Anticoagulation Clinics, Henry Ford Hospital, Detroit
Dialogue between physicians and patients
Albert O. Meyer, Berne, Switzerland
and Hermann Kruettner, MD, Grossgmein, Austria
Travel in patients on anticoagulation
Heinz Voeller, MD, of Rüdersdorf, Germany
Perioperative management of anticoagulation
Jack Ansell, MD, Chairman Department of Medicine, Lenox Hill Hospital, New York
Emergency reversal of anticoagulant therapy
Marcel Levi, MD, Academic Medical Center, University of Amsterdam, the Netherlands
Self-monitoring in real-life practice
Chris Gardiner, PhD, Department of Haematology, University College London Hospitals, London, United Kingdom
What will the future of anticoagulation look like?
David Garcia, MD, Albuquerque, USA
Photo: Chairpersons of 10 European national organizations.
ISMAAP 2009 - Convegno a Bruxelles
INR Self-Management – A model for the future
The 10th National Conference on Anticoagulation Therapy was held May 7th – 9th 2009 in San Diego, USA. I attended as the representative from the International Self Monitoring Association of Anticoagulated Patients (ISMAAP).
During the conference, it was discussed with more than 700 participants, whether INR self management is a beneficial approach. Lynn Oertel, Boston, raised the question, whether INR self management is really a new approach and referred to Germany, where 20% (160,000) of patients on anticoagulation therapy perform INR self management. In contrast, only 1% of US patients perform INR tests at home, no one even to talks about self- management.
Menorrhagia is common in patients on oral anticoagulation with vitamin-k-antagonist phenprocoumon
Objectives: To assess the menstrual blood flow of 46 women on long term oral anticoagulation (OAC) with phenprocoumon in comparison to normal values from the literature.
Reimbursement in Europe
In some countries, doctors generally or the thrombosis service agree that patients should manage the self-monitoring of long-term oral anticoagulation on their own and take control of their anticoagulation therapy. In these countries, reimbursement of the necessary equipment for self-monitoring is usually granted by the national health insurance authority.
However, in other countries, self-monitoring of long-term oral anticoagulation can be carried out only in very close cooperation with the general practitioner and/or the lab. In these countries, reimbursement by the national health insurance authority of the necessary equipment is for self-monitoring not yet possible.
Education, Training, and Self-Management not only for Seniors
Patient education and training is a substantial part being anticoagulated in order to know how to deal properly with Oral Anticoagulants.
Misconceptions that alarm anticoagulated patients
We check everyday that many anticoagulated patients are overwhelmed and scared by warnings and prohibitions, usually absurd and unfounded, from relatives or friends, and even sometimes from the medical staff. We refer to drugs and food that anticoagulated patients are or not able to have.
Embolism and Thrombosis
As a member of the Health Group FEASAN, I considered it to be advisable to write this short article on thrombosis and embolism in order to clarify some concepts that might help us to understand appropriately their right meaning. This description is due to the fact that, on many occasions, both terms are mentioned indistinctly, missing their exact differences, either etiological, structural or clinic ones.
Remboursement pour les enfants
Prise en charge du CoaguChek®XS ou de l’INRatio® pour les enfants.
Les enfants, de moins de 18 ans, sous AVK au long court pourront à partir du 7 Juillet 2008, bénéficier d’une prise en charge totale des autotests de l’INR (CoaguChek® XS, INRatio®) et de leurs bandelettes (en boite de 12 pour l’ INRatio® et en boite de 24 pour le CoaguChek® XS).
Les arrêtés ont été publiés ce matin au Journal Officiel de la République Française ( N° 0146 du 24 Juin 2008).
Safety for anticoagulated patients in Spain
Control of anticoagulation is carried out daily to near one hundred thousand patients at Spanish Hospitals and Health Centres. The Spanish Anticoagulated Patients Associations need to question whether such controls are carried out correctly at those Hospitals and Health Centres.
Last modification: August 31, 2010
Please note this website should not be used to replace advice from your doctor.