INR Telemonitoring: Efficacy and Safety of a Telemonitoring Program in 453 Patients.

Acta Med Port. 2012 Sep;25(5):297-300. Ferreira F, Antunes E, Neves RC, Farias F, Malveiro P, Choon H, Galrinho A, Cruz Ferreira R. Serviço de Cardiologia, Hospital de Santa Marta Centro Hospitalar de Lisboa Central. Lisboa. Portugal.

Introduction: The INR analyses of patients taking oral anticoagulants brings great burden to healthcare professionals, overspendingfounds from the National Health Service (NHS) and loss of quality of life of patients who are forced to frequent hospital visits. It shouldnot be surprising that the technology is at the forefront of health care nowadays and some projects have been developed in the areaof anticoagulation for INR self-monitoring by telephone, mobile phone or internet. The aim of this study was to assess the efficacy andsafety of an INR telemonitoring system that was implemented in our hospital in 2006.

Methods: A prospective, observational study of 453 patients who were included in this telemonitoring system from 2006 until late November2010. The communication between patients and health professionals was done via mobile phone messages in a standardizedand codified system that included information about maintenance or modification of therapy and the date of the next evaluation. Whennecessary the patient could send a request for help through a code for that purpose. In the studied population the following parameterswere evaluated: withdrawal of the telemonitoring project, need for change of anticoagulant dose, requests for clarification by the patient,hospitalization for bleeding complications and INR > 10.

Results: In our study population 53% were female, mean age = 57 +/- 16 years. The percentage of INR values within the therapeuticrange was 83%. There were no dropouts of the telemonitoring project. The percentage of patients with major and minor bleeding complicationsduring follow-up was 0.4% and 0.2% respectively.

Conclusions: The telemonitoring system proves safe and effective remote monitoring of INR analysis, allowing efficient monitoring of INR with low prevalence of major or minor bleeding.

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