Why? Because I have an artificial heart valve since 1987. Therefore I need to be anticoagulated. Since 1987 I use a self-monitoring device which allows me to control my INR values by myself. This breakthrough technological discovery has given me and worldwide 300,000 anticoagulated patients a great deal of freedom and independence.
Advice:
- Test your INR once per week (as an exception: once every two weeks if you are very stable).
- Test more often in special situations (e.g. fever, new drugs, stress, vacation, change of climate, change of diet).
Patient self-management offers significant benefits, since it is proven that fewer complications occur if you self manage.
One drop of blood a week is enough to measure your INR yourself and to adjust your dose if necessary. You will have flexibility of when and where to test.
„Coagulation self-management involves great self-confidence. The experience of self-dealing with anticoagulation brings a higher quality of life.“*
* Schaefer C., Enabling patient self-management, Hospitalhealthcare 2014
Use simple tools, like a checking off a day on your diary, Apps.
If you need to change the weekly dose of your anticoagulant: challenge yourself!
- Have I missed a dose?
- Was it a stressful week?
- Where there changes in lifestyle (more/less alcohol, diet)?
- Did I have to take an additional drug?
- Did I take a prescription free drug? - Painkillers often contain aspirin
Adjustment of dose:
- Only adjust the dose, if your INR is outside your target range.
- If there are larger variations, the weekly dose needs to be adjusted.
- If the INR is >5.0, call your HCP immediately.
- If you INR is <1.8, contact your HCP.
- Therefore: measure your INR within 2-3 days after taking a new drug for the first time.
- Avoid drugs containing aspirin (Caution: aspirin is often found in painkillers and anti-cold drugs).
- Look out for advice on drug-drug interactions in package inserts. Read them carefully.
- Influence of food is lower than expected.
- Nothing is forbidden, but watch out if you change your diet to lose weight.
- Vegetables, rich in vitamin K, seem to support a stable anticoagulation treatment.
- Enjoy alcohol responsibly and try to give up smoking (not only for anticoagulation).
- Change of lifestyle, e.g. remedial fasting.
such as:
- Fever
- Diarrhea
- Stress
- Mental problems
- Start of exercise
- Change of climate
- Holiday
How does effective and safe anti-coagulation treatment look like?
Stable INR-values that are in the therapeutic target range over a long period of time. Consider your individual target range.
(Natalie Oake, et. al., CMAJ 2008: the lowest complication rate (4.3%) was shown for INR values between 2.0 and 3.0. The relative risk was a 2.7 fold increased for INR values between 3.0 and 5.0. For INR values > 5.0 the risk for bleeding is a 21.8 fold increase. INR values <2.0 increase the thrombosis risk 3.5 fold)
You can enjoy an active lifestyle if you are on anticoagulants, whether it is in the mountains or at the sea. It is important to measure you INR regularly and to listen to your own body.
