Home PT Testing

[guyinva]

I am currently on Coumadin for Atrial Fib and getting tested every other week. I will be having an Aortic mechanical valve replacement and Aortic Aneurysm repair in October. Doctors tell me that I will be on Coumadin for the rest of my life and will have to get regular PT/INR tests done. I've read some about home PT Testing. Was wondering if anyone is using home PT Testing and if so, which one are you using and how accurate is it?

 

[dick0236]

If you were on Medicare, you could go on home testing after 3 months on Coumadin and it is covered under Medicare. Since you are under 65, and I assume, not on Medicare, it depends on your insurance company. Some cover it and others do not, althogh if you push hard enough, many will cover at least some of the expense. Go online and search under "Home INR testing" for possible sources of equipment. Two of these sources are....Alere and Philips and you can find their contact info online.

I use a Coaguchek machine thru a program monitored by Alere. The accuracty is AT LEAST as good as the results from docs office or lab.

 

[Protimenow]

What Dick failed to say is that he's using a CoaguChek XS machine. The CoaguChek S, an earlier model, was replaced by the XS and Roche will stop supporting it after next October.
Many on this forum also protest love for the InRatio and the InRatio 2 machines.

The ProTime and ProTime 3 seem to be the least favorite of those on this forum -- these machines are larger than the other three, take more blood, and the strips require refrigeration.

All of the meters I've listed have quality control testig built into the strips.

Personally, I use the ProTime 3 and have wasted no strips using this meter. I also have a CoaguChek S, but am not quite as confident in the results because there are no quality controls built into the meter (and I've wasted quite a few strips). (The main reason I started with the ProTime is because I don't have insurance to cover the cost of the meter and supplies, and I was able to get my meters quite affordably on eBay.)

 

[Freddie]

I use the Coaguchek XS and my INR range is 2.5 to 3.5 I have also learned that when getting a vein draw the lab/clinic will do 3 tests to measure your INR and do an average of the 3 tests with a variance of .2 (that's what they do here in Canada) As for accuracy of a home monitor, it has been said that home monitors can read a little high, but I have learned by doing comparing tests from vein draw and monitor for over a year, that if I keep my monitor results between 3.0 and 3.5, the lab will have a difference of about .3 lower than what my monitor reads.
The Coaguchek XS also comes with a carrying case to keep all your supplies together, it's small and compact.

 

[Protimenow]

Research available at the Roche site for professionals, and I believe also on the ITC ProTime site show independent lab reports comparing lab readings to meter readings. The CoaguChek XS will report higher INRs a bit above the lab results -- for example, a 3.5 on a lab report may be reported as a 3.6 or 3.7 on the meter. Lower values (in the 2.0-3.0 range) don't show the difference. I'm not sure of the specific values where this difference shows up, and haven't researched this recently, but I think the InRatio also reports the higher values a bit higher than the lab results. The ProTime, which uses a different method for testing, doesn't have this issue.

The point here is that, while these tests can be extremely useful guidelines for dosing, when a meter shows a value that is out of range, it may look MORE out of range than it actually is - and it may cause you or whoever is managing the anticoagulation to overcompensate. (If your meter shows a value that seems way out of range, a lab test with a blood draw can be used to check the result your meter reported).

It may be good to keep this slight difference from lab results and meter results at higher INRs in mind when considering how to manage slightly out of range INR.

 

[njean]

The first machine I had was a Roche CoaguChek acquired through Tapestry. You always had to conduct a pre-test, which involved using two little vials that had freeze dried rabbit brains (NOT kidding). If the pre-test came out okay, then you proceeded to test your blood. I thought it was the most pre-historic, time-wasting thing & I absolutely hated it! And it seemed that they had a recall for the strips frequently. I finally got so fed up that I sent it back to them & demanded a refund. I was not refunded all of my money and settled for a little over half of the total cost. But I was rid of it and that was good.

I then bought an INRatio 2 machine from QAS (now called Alere), and have been really pleased with it. Since I am on Medicare (SS Disability), Medicare pays for the strips but the requirement is to test weekly and call in your results to Alere.

I hope that you can get your INR machine soon....you will love the freedom that home testing will give you!

 

[hook]

I use it and test every week. I find that it is about .4 over what the lad draws show, but I can predict this variance so it is no big deal.

You should get your doctor to write a letter to your insuance and say exactly this.

"My patient will be on coumadin for the rest of his/her life due to a mechanical valve proceedure and will require weekly testing"