Coagulation self-testing

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Is Coagulation Self-Testing Right for You?

 

If you are someone who has recently been prescribed anti-coagulation therapy, you will have been informed by your doctor about the need to ensure that your blood is regularly checked for its clotting time. The good news is that modern technology now means that you can conduct these tests yourself, painlessly, quickly, and without the need to visit your local hospital.

The reasons for the prescription of anti-coagulation therapy differ from patient to patient, but the aim of the intervention is ultimately the same; to prevent the formation of unwanted blood clots. The blood’s ability to clot is a wonderful design of nature and will have saved everyone’s life at one point or another. When blood escapes from the body - as in the case of a cut or injury - it is blood clotting that prevents us from bleeding to death. However, blood can also clot within the body’s vessels in certain situations, with some health conditions predisposing this clot formation. In these cases, the microscopic ‘plugs’ of blood can travel around the body in the blood stream before becoming stuck in a narrow artery, blocking the flow of blood and oxygen. If this blockage occurs in one of the body’s vital organs, -such as the heart, lung or brain - then the consequences can be serious, even fatal. Anti-coagulant therapy is designed to prevent this from happening.

The reason for the need for careful blood monitoring during anti-coagulant therapy is that everyone’s clotting time will respond differently to the prescribed medication, meaning that dosages need to be carefully titrated on an ongoing basis. If the clotting time isn’t sufficiently long enough during therapy, blood clots may still form. If it is too long, there is the danger of internal bleeding. Getting the right balance is therefore critical.

In previous years, regular blood testing to check clotting time, known as the ‘PT/INR’ (Prothrombin Time/International Normalised Ratio), was a procedure only ever conducted at established health institutions. This was because the analysis machines were specialised, expensive and took up a lot of space. A patient would be required to attend their local hospital to have their blood taken and return a few days later to receive the results and speak to their doctor about any therapy changes. With each test typically required on a two-weekly or monthly basis, the procedure involved a great deal of time taken up both with the appointments and with travelling to and from them.

However, modern technology has changed all this. Thanks to considerable advances made in anti-coagulant testing, patients are now able to use a hand-held device to conduct their own blood analysis with a finger-prick in much the same way that diabetics monitor their blood sugar levels. Not only does this do away with the need for regular visits to the hospital for blood tests, but the follow-up in-person consultations are also not necessary, as built in Bluetooth technology enables medical interpretation of results to be carried out remotely. It all adds up to patients on anti-coagulation therapy now being able to enjoy much more independence and freedom than was previously possible.

If you are a patient who is keen to benefit from using a self-testing anti-coagulation monitoring device, there are a few precautions you should undertake to ensure that you remain safe. You need to establish with your doctor the frequency of your testing regime and ensure that you stick to it. You should also report to them immediately any spontaneous episodes of bleeding or bruising. If you are travelling, you need to ensure that along with your device you take its charger, sufficient spare batteries and enough testing strips to last for the duration of your trip. You should keep with you your medic alert that informs of your condition and keep a letter from your doctor that explains that you are receiving anti-coagulant therapy with your health insurance documents. It’s possible that a change in heat, humidity and activity when on holiday may affect your clotting times, so ensure you conduct your self-checks regularly. In the case of pronounced fluctuations in the results, you should consult a physician at your travel destination.

Self-testing, as so many have attested, offers a whole new lease of life for those receiving anti-coagulant therapy. Not only does it provide freedom from repeated hospital visits, it also puts the patient in charge of managing their condition. This imbues them with confidence, alleviates their feelings of helplessness and gives them a sense of empowerment. If you are a patient who is receiving anti-coagulant therapy and are yet to be introduced to the benefits of self-testing, you should speak to your doctor at your next visit.