Monitoring Anticoagulation at Home

Monitoring Anticoagulation at Home

Are there any options for do-it-yourself monitoring?


While most people on warfarin or Coumadin® go to an anticoagulation clinic to monitor and test their blood’s clotting time, some people are able to do their own testing and monitoring from home. People who do so may feel a greater sense of control and ability to take part in managing their own care. This option is especially valuable for people who maintain a full schedule, enjoy traveling, or have other reasons that make it difficult to get to the clinic. The need for testing and monitoring at home only applies to people taking warfarin or Coumadin® for stroke risk reduction using anticoagulation medication; NOACs do not require testing.

Who is a good candidate for at-home anticoagulation monitoring?


If you have been diagnosed with atrial fibrillation and have been taking warfarin or Coumadin® for at least 90 days, you may be eligible to begin testing your INR or clotting time (also called Prothrombin time) from home. If you’re interested and willing to manage your part of the process, your healthcare provider can submit a request to authorize you to complete your testing and monitoring requirements from home. From there, you’ll work with your insurance provider or national healthcare benefits program to arrange for any necessary payments and connect you with a monitoring company that will provide the equipment and teach you the steps for timely and accurate measurement.

What is the process for at-home monitoring?


Most medical coverage options allow for weekly or bi-weekly testing, and the testing must usually be communicated back to the monitoring company who then communicates it to your doctor so that you can maintain a prescription for your medication. The monitoring company will alert your healthcare provider if results of your blood clotting time are out-of-range so your doctor can promptly adjust your dosage. This regular communication also allows the monitoring company to track your usage and send additional supplies when your usage data indicates you should be running low, which will save you time and energy.

People who monitor at home will likely want to create a convenient place for storing supplies, testing, and reporting results. During training, your monitoring company may help you work out a system to remind yourself when it’s time to test.

We encourage you to talk about your experience and share tips and insights with other users at our online forum.

Learn more about clot times, lab testing, and what your ratio means by visiting our Anticoagulation Lab section of AFib Town.

Recent Discussions From The At Home Forum
barbara1642 avatar

Do patients with a-fib ever get pacemakers?  I haven't posted lately because I've been fine.......and having other issues:  dental & cataracts.  The joys of getting old.er.   

So do we fibbers ever get pacemakers?  2 days ago I had an "incident", and I think my heart wants to go into a-fib, but it doesn't quite make it.  I have an appt w/my cardio this morning.   

 

I'm just curious..............

~barbara  

live long & prosper

Barbi1 avatar

hi I’m new , I was diagnosed with Ischemic in May , had surgery 8 May I went AFIB on the table , I hope I’m saying this right .  I’m on xarelto . I need advice on eating right .  Thanks Barbi 

maria12045 avatar

This concerns my father.

Age: 62, caucasian male

Location: Greece

Weight: 71kg

Height: approximately 175cm

Diagnosis: dilated cardiomyopathy and atrial fibrillation (he is currently not in a-fib: his atrial fibrillation stopped after ablation)

Other conditions: none besides retinal detachment in one eye, and raised intraocular pressure in the other which he treats with eyedrops; and two instances of bells palsy in the past.

Current prescription:

Xarelto 50mg (rivaroxaban)

Entresto 100mg (sacubitril/valsartan)

Carvepen 25mg (carvedilol)

Eleveon 50mg (eplerenone)

He also took Zyloric 100mg (allopurinol) to manage uric levels which he quit along with the above.

.

September 2016 my dad went to ER with chest/abdominal pain. They found he had EF of 24% and left ventricle 60mm.

His latest check up, April 2019 he had a cardiac ultrasound showing EF of 55-60%. Left ventricle approx 53mm.

On June 7, 2019 (three weeks ago now) he stopped all meds without telling anyone -not doctors or family- because he feels he doesn‘t need them. He had back pain, joint pain, fatigue and complained of insomnia and cited these as his reasons for stopping. However, I recall him beginning questioning the necessity of meds as soon as he got rid of the AF by ablation. He has been reading studies about the long term side effects of heart medications and this motivated him to quit as well.

Since finding out three days ago, myself, family and his doctors have advised him to restart but he is ignoring this advice because he says he feels great since the side effect symptoms (back pain, fatigue, etc.) have stopped and he is checking his blood pressure regularly as a safety measure.

As to why he would doubt the medicines when it has been demonstrated that they work, I believe the answer is the following: since the beginning, his doctors described the cause of his condition as a chicken and egg situation (did heart enlargement cause the atrial fibrillation or vice versa?). I believe my dad started to attribute the cardiomyopathy to the a-fib. Therefore, since he is currently physiological (despite the fact that this a result of therapy) he thinks he only has to watch out for another episode of a-fib.. He thinks the medications have already done their job and are now just damaging his health unnecessarily. But he needs to be explained that they still are doing their job. And that the risks outweigh the side effects.

I am hoping for information about how the medicines are still contributing to his heart. And about the risks of stopping. But any feedback at all from patients, family of patients as well as medical professionals would be appreciated so much as I am at a loss.

Thank you for very much for reading.

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