EFFICACY OF INR SELF-MANAGEMENT LED BY PATIENTS IN PREVENTION OF READMISSION AND THROMBOEMBOLIC EVENTS ON WARFARIN OR ORAL ANTICOAGULANT THERAPY

Valvular heart diseases affect millions of patients worldwide, and the burden is rising as the population ages. Severe valvular heart disease is associated with significantmorbidityandmortality,claimingover50,000lives annuallyintheUSA(Poli, Antonucci et al. 2018). Coumadin (generic name: warfarin) is an anticoagulant, which stops the formation of blood clots and makes blood thinner (less viscous). As for Vitamin K, it helps the process of blood clotting. In other words, warfarin has the opposite effect to Vitamin K. Warfarin is a widely used and cheap drug which decreases the risk of thrombosis or embolism in patients with diseases such as atrial fibrillation (AF), venous thrombo-embolism, and mechanical heart valve surgeries. Treatment with warfarin requires close monitoring with regular tests of PT-INR for better outcome of patients (Morgan, Anstey et al. 2019). The purpose of the study is to shorten and simplify the process for the testing and prescription of warfarin by introducing point of care analysis (POC). The aim was also to evaluate changes in time and cost related to the new processes. Effective management of warfarin therapy is frequently challenged by its difficult pharmacology and adverse effects. One strategy to ensure safe warfarin use is provision of comprehensive warfarin education to patients regarding self-testing and self-management of accurate dose according to INR value. Point of care INR monitoring has shown beneficial impacts on the risk of thromboembolic events, anticoagulation control, patient satisfaction, and quality of life(Sharma, Scotland et al. 2015)