Exploring point-of-care testing of capillary blood in warfarin management

Background: Long-term warfarin therapy requires intensive laboratory monitoring of venous blood. Reliable and efficient point-of-care testing (POCT) of capillary blood offers an alternative to laboratory monitoring. Aim: To explore the perceptions of health professionals to POCT in warfarin management and to identify the models of monitoring warfarinised patients preferred by health professionals. Method: An exploratory descriptive study that purposively sampled health professionals (hospital pharmacists, specialists, nurses, general practitioners) involved in the management of anticoagulated patients and practising within an area health service. Health professionals were invited to participate in a group discussion on POCT and to then complete a brief survey ranking proposed monitoring models incorporating POCT. Results: 4 group discussions and/or individual interviews with 33 health professionals elucidated several themes, such as lack of knowledge or confidence in POCT, operator accreditation and careful patient selection. An acute post-acute care model and general practice surgery model incorporating POCT was preferred by health professionals in terms of perceived benefits to patients, cost-effectiveness and time efficiency. Conclusion: POCT will be a component in the monitoring and management of warfarinised patients in the future. A drawback to POCT is the perceived inaccuracy of the devices used. Operator training and maintenance of a controlled practice environment were suggested strategies to overcome variability