devices for home self-testing PT or INR

  1. I don't recall seeing any self-testing devices for PT or INR in client homes, but I read about them - such as Coaguchek, ProTime, Avocet

    many people have their own devices for checking blood sugar

    does anyone know which devices are considered to be the best for checking PT?
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  2. 32 Comments

  3. by   cookie102
    i like to use the INRATIO, simple to use......these machines can cost up towards $1000.00, glucometers you can get free from the reps...that is why i don't think you would see people having their own, even if they were taught how to dose coumadin.
  4. by   kimmie518
    Why are these machines use?

    Does the patient have a "sliding scale", like insulin, when it comes to medication dosages?
  5. by   GingerSue
    these devices are for checking prothrombin time or international normalized ratio

    for a person taking warfarin, and the dosage is changed according to the results, after the doctor has been notified of the PT or INR
  6. by   txspadequeenRN
    i don't know anything about the machine or how to use it but it sounds like a bad idea to me. pt/inr values are nothing to mess with and it is my personal opinion that it needs to be drawn and ran by a professional lab...your dealing with adjusting a drug that can do you in if not correctly dosed...just my opinion.
  7. by   GingerSue
    same as with insulin, and people do their own checking of blood sugar at home - see what I mean, and the devices are mentioned in my textbook for home self-care
  8. by   MS._Jen_RN
    I, as a homecare RN, use the Inratio meter. I know several MDs offices that use them for in the office testing. They work similarly to a blood glucose machiene. The drop of blood you need is bigger though. We call the MD with results. They are great for patients who are "hard sticks" and don't have a CVC. I haven't seen the patients use them. Like someone said, they cost big $. I love them for homecare. (Plus, I hknow right away. No drive to the lab and waiting.)
    ~Jen
  9. by   gauge14iv
    I have a relative on coumadin who travels for work - there is not always a lab available where he is. His only option is to use a machine and call his result in to his docs office who then tells him how to adjust his dose.

    Other situations might include a home bound patient who can't be transported to the clinic or lab and who doesn't qualify for home health care, a patient in a rural area who must travel many miles to get labs drawn...any other number of situations.

    These machines are NOT designed for a patient to make their own medication adjustments, they are merely available to patients who must monitor their levels so their PROVIDER can adjust their meds and for whom doing so in the traditional manner would create some sort of hardship or difficulty.
  10. by   GingerSue
    sounds like you, the nurse, do the testing then contact the MD

    the Inratio meter that you have - is it owned by your employer, by the patient, by the health care system?

    maybe the client's insurance would help cover part of the cost? same as they do for glucometers, and all kinds of other devices (wheelchairs, adjustable beds, diabetes equipment, oxygen equipment, etc)
  11. by   gauge14iv
    My relative purchased his own machine.

    Medicare/Insurance does cover these depending on condition
  12. by   MS._Jen_RN
    Quote from GingerSue
    the Inratio meter that you have - is it owned by your employer, by the patient, by the health care system?
    The home care agency owns the meter. I think that if the patient met certian criteria, as discussed by someone else above, the insurance company might cover all or part of the cost.
    ~Jen
  13. by   GingerSue
    maybe like so many items - if there is a doctor's written script then the insurance will cover part of the cost, worth checking into

    maybe the local drugstore can give an idea of the cost
    or the local medical supplies shops
  14. by   Pam RN
    I have the Coaguchek machine by Roche. I had a Mitral Valve Replacement 18 years ago this May and have been using the machine for about 8 years. After 10 years of needle sticks my veins were getting pretty scarred and as someone mentioned getting to a lab is not always convenient, especially when out of town. My cardiologist is in another city 90 miles from where I live so when I had my blood drawn at the hospital I worked at or at a hospital near my house it's a hassle because my doc is not on staff.

    The company recently recalled the strips a few months ago and the FDA won't be approving new ones until April so back I went to the lab and I hate it. The machine could be improved due to size and the amount of strips used to run the controls but it really is so much better than going to the lab.

    There are guidelines such as if my INR is greater than 5 or 6 I do have to have a venous draw to double check the value. Also, being a nurse, the Coumadin Clinic gave me some additional instructions to follow that they wouldn't give the average patient such as holding my dose if my INR is higher than 4.7. I check my level on the day they tell me to and then call in my result and then they call me with my instructions. It's that simple. They also told me that the patients who are able to understand how to use the machine and perform a fingerstick on themselves and get the drop of blood on the strip correctly. If the nurses at the office feel the patient can't perform this then they would not approve home use for them.

    The home machine is not appropriate for every patient but I am so glad it's available as an option.

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