Patient self-management of oral anticoagulation and external quality assessment procedures

Ellen Murray, DP Kitchen, S Kitchen, I Jennings, TAL Woods, FE Preston, David Fitzmaurice

    Research output: Contribution to journalArticle

    23 Citations (Scopus)

    Abstract

    The role of external quality assessment (EQA) is a contentious issue for patient self-management (PSM) of oral anticoagulation. Patients from general practices in the West Midlands undertaking PSM were recruited to compare efficacy of patients' and health professionals' EQA procedure using the UK National External Quality Assessment Scheme (NEQAS). Patients using Coaguchek (Roche Diagnostics) were trained to perform EQA as part of their PSM training. They undertook PSM for 26 weeks and were asked to perform EQA using material provided by the UK NEQAS twice at home without supervision and twice at the practice with supervision. Patients' results were compared with health care professional users of Coaguchek S. Twenty-three PSM patients were compared with 75 health care professional users of the NEQAS scheme. The PSM group international normalized ratio (INR) percentage time in range was 74%. There was no significant difference in the median results on NEQAS samples obtained by the patients and those obtained by professionals. Three patients were outwith consensus (results > 15% from the median INR) on more than one occasion. Patients were able to perform the EQA tests competently. The data show that good agreement can be achieved between patients analysing the same EQA samples, with coefficients of variation ranging from 22.3% to as low as 5.4%. Further study is required to determine how precision within these EQA schemes relates to the stability of treatment in patients' management of their own anticoagulation.
    Original languageEnglish
    Pages (from-to)825-828
    Number of pages4
    JournalBritish Journal of Haematology
    Volume122
    Issue number5
    DOIs
    Publication statusPublished - 1 Sep 2003

    Keywords

    • training
    • patient self-management
    • external quality assessment
    • supervision
    • oral anticoagulation

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