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
Arline3366 avatar

Does anyone cut the 25mg table of metoprolol in half due to shortness of breath when walking and/or dizziness?  I asked my primary care dr and he did not recommend cutting the tablet because it may lead to AFib.  I plan to ask my cardio dr when I next see him.  I currently take 25mg both morning and night.  I'm in my 80s now and am wondering if it's too much.

Spencer avatar

Thor's final walk was early this morning.  My wife and I walked out onto a deserted beach near the house early this morning and spread his ashes on the beach. He loved this beach.  We had to stay in a hotel right across the street from this beach while we waited to buy our current house.   So we would walk each morning before work (4:30 AM), and he would walk off leash on the beach for miles.  He ran around like a puppy nut.  

Pix is from a few years back; we were coming home from a trail jog.   

 

bshersey avatar

1.) Doctors, EPs in particular, undersell ablation recovery. I had my ablation on a Wednesday. My doctor said I could resume full exercise on the following Sunday and start work Monday. Not quite. I'm four months out now and just starting to feel like doing more than my basic daily walking. I was exhausted and barely functional for at least a month afterward.

2.) Everyone's recovery is different. Some people have no pain. My mom has had four ablations and said she never had any chest pain. Others feel a lot of pain. Some people are up and running quickly. Others say it takes 6 or even 9 months to feel fully recovered. Follow what your body says first. Guidelines are just that. They aren't etched in stone.

3.) Be your own advocate with the medical folks. I took myself to the ER four times in the weeks after my ablation for chest pain. No matter how trivial some of the doctors made me feel, I am happy I did it. It got me to the front of the line for a nuclear stress test and a cardiac cath, which I should have had before the ablation. I passed both and now breathe a lot easier. Now my post-ablation pains are just another pain to deal with, not a potential cardiac event.

4.) Medications have side effects and if one isn't working for you, let your doctor know. You two can always try others.

5.) Forums like this are a big help. Once I found this community I was able to pose questions, get answers and share my pain - literally - with folks who understood. It gave me a lot more stamina and ammunition for dealing with the medical establishment on an ongoing basis.

Those are my top 5. I could easily have done 10. If you have any other knowledge to share, please go ahead and reply to me and the rest of the community.

 

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