Best INR & warfarin dosing app

[Brinntache]

Hi all, thought I would share since I had a pain finding a decent app and no threads here.
Settled on 'INR Diary'.
https://www.inrdiary.com/ plus google/amazon/apple stores.
Allows me to track my INR, set reminders for my home testing, set a schedule for my warfarin dosing (which varies by day of the week), and a few other things. For me worth the couple of dollars. It's not perfect, but it was significantly better then the few others I tried. The reminder/alarm is pretty weak, so my real alarm is an annoying speaking one my daughter programed into my phone.
Anyone else with an opinion, a different option or suggestion?

 

[pellicle]

I have considered making an app, but have instead shied away from it due to litigation possibilities.

For me none of them are worth any money as I make a spread sheet for no additional cost.

 

[pellicle]

and no threads here.

https://www.valvereplacement.org/th...inr-monitoring-and-warfarin-reminders.865426/
https://www.valvereplacement.org/threads/best-inr-tracker-app-for-android.860294/
just as a starter, could be more

 

[Warrick]

INRlog is really good.
https://www.valvereplacement.org/threads/self-monitoring-inr-from-the-start.887964/post-905172

 

[Al3x]

I'm using INR Diary as well. I agree the alarm isn't great but I use my wristwatch for that instead. Otherwise I think it's an excellent app.

 

[JohnDeezer]

I heard that Warfarin Manager is pretty good. This app allows you to set reminders, track your INR levels, and monitor your diet.

 

[LondonAndy]

I am impressed with the efforts you guys go to. In my case, my INR is pretty stable - I have been on the same daily dose for the last 2 or 3 years, with only occasional minor and temporary adjustments. The CoaguChek XS machine of course keeps a record of 100 (I think) measurements, with time and date, and my attitude is that if my INR is getting towards one end or the other of my range I just adjust the next Warfarin dose up or down 1mg, then return to normal. If a larger change occurs then as long as I have a reasonable memory of what has been different that week (eg am I on holiday drinking more alcohol? Or am I on antibiotics/got a cold) then the dose change might be for a couple of days before returning to normal. If things start getting more significant, requiring regular changes to dose, then I would start logging more info.

 

[pellicle]

Hi John and welcome

I heard that Warfarin Manager is pretty good. This app allows you to set reminders, track your INR levels, and monitor your diet.

some years back I did a review of the software systems which are available to the "big users", to my knowledge they are all similarly promising around 60% Time in Range. I found that the NHS uses Dawn
https://www.4s-dawn.com/products/anticoagulation/dawnac/
I've reviewed a few others (done as PhD theses by one or two players). They all have a low bar in my view. Basically what this means is you can't expect anything better than that on a phone app.

I've worn a few hats in my professional career and when looking at security I'd say the less apps you have on your phone the more secure it is. From INR standpoint I'd say that all phones support alarms for reminders and that the whole diet monitoring thing is the last 5% of what makes your INR pendulum swing ... assuming you follow a healthy diet and don't do wild and weird things like some fad diet where you eat only grapefruit for a month (which will send your INR into orbit).

Avoid drinking alcohol in big binges and preferable be a steady 1 or 2 a night guy.

Lastly I'll say that you can keep a spreadsheet on something like Google drive which is backed up automatically, has version history and is entirely private. You can enter data to it via your phone or via your PC (much nicer tool for that job). If you want a better mousetrap please reach out and I'll set one up for you on Google Sheets and talk your through it (sorry if you use iPhone, that won't cut it because Google is Apples competitor and you will need a Gmail address to have authentication to access your sheet). I'd anticipate that no matter what you'll get >80% Time in Range with my method.

Best Wishes

 

[pellicle]

Hey Andy ...

Or am I on antibiotics/got a cold) then the dose change might be for a couple of days before returning to normal.

I'm willing to bet you can pick with accuracy when I went off antibiotics (which if you recall I was on for about 10 years prior due to my fun post surgical ride). Giving up 100% cold turkey any alcohol (thanks COVID) is in there too...

Turns out now that I'm off that (for now, its still too early to be sure) I don't need all the systems I developed to manage my personal INR rodeo ;-)

 

[sharky7]

I heard that Warfarin Manager is pretty good. This app allows you to set reminders, track your INR levels, and monitor your diet.

I think the reminder that I use is perhaps ole school, although for the most part it works awesome, it is a calendar. I mark down when i take my meds, vitamins, etc. and it is done, I also use something else to make it KISS, I use those snap pill holders. The one i currently own is awesome, it is large to hold all of everything I take, and it will hold a supply for two weeks. I keep all my MEDS, INR machine, etc. all in one place. It helps tons to keep somewhat organized, and when it is your health, than the benefits are priceless!
I do make errors once in awhile even though I do all of that, AND I do have a, plan B. Which is this, for me, and I find that it works! I take my missed dose ASAP when I become aware of it, and then make sure my next dose is not any less than 12 hours apart from that! Than the next day I return to my regular schedule! I check my INR to make sure where I am, and wala, its like magic! I usta goes apsie, and NUTSO if I missed a does, and if ya plan for it, it doesn't need to be so bad! Now if ya dont for whatever reason, HOME TEST. then this would be for you, almost impossible to do! This is for I guess then, for those of us that are home testing and have been so for around 1-2 years! AND EVERYONE.....please..live long and prosper, SPOCK!

 

[JohnDeezer]

I heard that Warfarin Manager is pretty good. This app allows you to set reminders, track your INR levels, and monitor your diet.

CoagTrak is also reliable. It helps you manage your warfarin therapy by tracking your INR levels, scheduling your next test. I suggest you to analyze more options and bases on the reviews to make a decision. At least, this is how I chose the app from smartengines.com and I don't regret it. I hope you find these suggestions helpful. Please remember to consult with your healthcare provider before making any changes to your medication regimen.

 

[pellicle]

Hi

Please remember to consult with your healthcare provider before making any changes to your medication regimen

unless you're one of the vast uninsured or someone who (like those of us who self manage) fit into.

• don't have a health care provider managing us (because they can't afford it)
• don't want one (because they are not that good)
• legitimately don't trust one (given their rather shoddy Time in Therapeutic Range values of just over coin-flip success of 60%)

This is not guidance for you, but just saying that probably less than half the people in the world on warfarin (maybe even in the USA) fit into one of the above bullet points.

 

[dick0236]

Please remember to consult with your healthcare provider before making any changes to your medication regimen.

Please do the above. I've been on warfarin long enough that I thought I knew what was best for me.......not sure anymore. For decades my INR was extremely stable, 2.5-3.5 and I made few adjustments over the last few decades (5mg daily). Last spring I was diagnosed with a heart/lung disease (Pulmonary Arterial Hypertension). That diagnosis has created a whole new set of INR issues due to.....adding Oxygen therapy 24/7, loss of energy, appetite, etc. It was almost like "a perfect storm" and my "stable" INR went out of control. I did self test at home until a few years ago and returned to docs lab after difficulty with the remote testing lab. I am still a big believer in home testing......but not sure about self-managing. It's great so long as things go well and INR is reasonably stable.........but can be a nightmare when things go wrong.
Fortunately, I have a good Cardio, PCP, and INR lab manager.......so my advice for those of you without a lot of experience.....
"consult with your healthcare provider BEFORE making any changes".......if your provider won't, or can't, help find another provider. There is more to this story but I don't want to write a book........but like they say "the man who always treats himself has a fool for a doctor".

 

[pellicle]

Hey Dick

There is more to this story but I don't want to write a book........but like they say "the man who always treats himself has a fool for a doctor".

there are quite a lot of diabetics who manage to juggle blood sugar readings and insulin administration with readings considerably closer in frequency to hourly than weekly. Yet they've managed to do this with only better outcomes than back in the early days.

There is some other grey viewpoint between the two opposites of submission or foolhardy.

Personally I can say that I have people I've helped who were very at risk and the doctors were at their wits end to manage them. One in particular (who got a blood infection and was on quite harsh antibiotics) manages to be 85% in range with weekly INR readings.

I appreciate that you are struggling with head winds and if you are inclined I can show you what I do, it even just run that for you in parallel with what the clinic is doing for you. I hope they are keeping you in range more than half the time.

Sorry to read of you decline in health.

Best Wishes

 

[LondonAndy]

I am still a big believer in home testing......but not sure about self-managing. It's great so long as things go well and INR is reasonably stable.........but can be a nightmare when things go wrong.

I'm not sure what it is like in the US, but here in the UK the two methods are not mutually exclusive. I self-manage normally, but if the situation gets complicated for whatever reason I have the backup of a hospital anticoagulation clinic. That way it is the best outcome for both patient and health care system: patient convenience, closer monitoring, fewer complications such as strokes requiring hospitalisation.

 

[pellicle]

Morning

. I self-manage normally, but if the situation gets complicated for whatever reason I have the backup of a hospital anticoagulation clinic

You don't happen to have any stats from there on the

• Reduction of costs to the community
• The improvement in patient outcomes (reduction in events)

I don't want you to dig for it, only if you think you have it

 

[ScribeWithALancet]

I'm not sure what it is like in the US, but here in the UK the two methods are not mutually exclusive. I self-manage normally, but if the situation gets complicated for whatever reason I have the backup of a hospital anticoagulation clinic. That way it is the best outcome for both patient and health care system: patient convenience, closer monitoring, fewer complications such as strokes requiring hospitalisation.

 

[ScribeWithALancet]

LondonAndy Said - I'm not sure what it is like in the US, but here in the UK the two methods are not mutually exclusive. I self-manage normally, but if the situation gets complicated for whatever reason I have the backup of a hospital anticoagulation clinic.

In the US, it varies by anticoagulation clinic. Mine considers the methods mutually exclusive but the pharmacists will talk with you in general terms about what they would do in certain situations and get to the point where they give you worthwhile advice or comments. Some clinics simply refuse to cooperate. In Utah, I know of a clinic that almost but not quite makes use of the home test meter mandatory because of the long drive times across Utah to the clinic. Admittedly, they give guidance on how to use the meter to the users but even so, they encourage its use. So my only advice is shop around. One should be able to find an anticoagulation clinic that fits your needs although it may take some work.

Walk in His Peace,
Scribe with a Lancet

 

[pellicle]

Hi

Admittedly, they give guidance on how to use the meter to the users but even so, they encourage its use

just wondering about the phrasing above, "admittedly" followed by "even so" seems to imply that them giving you guidance is a bad thing?

Myself I think giving guidance is a good thing, unless said guidance

1. contradicts the goal of keeping in range
2. goes against the documentation of the meter.

as a generalisation I find that people always gift some person in the employ of a pharmacy or a clinic as being expert, unless they are unhappy with "those idiots" ...

Myself I tread the line of: evaluate what people say on its merits.

"Test and know thyself "