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5. Moore GW, Henley A, Cotton SS, et al. Clinically signi cant differences F2 between point-of-care analysers and a standard analyser for monitoring the International Normalized Ratio in oral anticoagulant therapy: a multi- instrument evaluation in a hospital outpatient setting. Blood Coagul Fibrinolysis 2007;18:287-92. 6. Donaldson M, Sullivan J, Norbeck A. Comparison of International Normalized Ratios provided by two point-of-care devices and laboratory-based venipuncture in a pharmacist-managed anticoagula- tion clinic. Am J Health Syst Pharm 2010;67:1616-22. 7. Cohen D. Manufacturer failed to disclose faulty device in rivaroxaban trial. BMJ 2016;354:i5131. 8. Van Den Ham HA, Klungel OH, Leufkens HG, et al. The patterns of anticoagulation control and the ALTHOUGH risk of stroke, bleeding and mor- SHE DID NOT tality in patients with non-valvular SUFFER ANY atrial brillation. J Thromb Haemost HARM, HAD A 2013;11:107-15. POC INR 39% and no phospholipid antibod- should be aware of the potential for 9. Johnson SA, Vazquez SR, Fleming R, CORRECTION ies were detected during her prior POC INR and CL INR disagreement et al. Correction factor to improve stroke evaluation. and work to develop institutional pro- agreement between point-of- FACTOR BEEN While the patient’s POC INR is cedures for con rmatory testing. POC care and laboratory International AVAILABLE AND elevated, the CL INR is within the INR correction factors are promising Normalized Ratio values. Am J Health APPLIED, THE therapeutic range. A local policy is tools to improve INR agreement and Syst Pharm 2017;74:e24-31. Trusted, above all. PATIENT’S in place requiring POC INRs >5.0 clinical decisionmaking. 10. Richter C, Taylor J, Shuster J. INCONVE- to be con rmed with a venipunc- Correction of point-of-care INR More CoaguChek® XS test strips are used CLIA-waived NIENCE AND ture sample and CL INR. However, REFERENCES results in warfarin patients. Point Care for point-of-care anticoagulation monitoring COST OF the patient’s INR is not above 1. Pendleton RC, Rodgers GM. 2016;15:1-3. 1 FOLLOW-UP this threshold and the pharmacist Disorders of hemostasis and coagula- 11. Goehe RR, Riddick K. FDA regulatory than all other brands combined. INR COULD remains perplexed as to which value tion. In: Greer JP, Arber DA, Glader oversight of POC PT/INR in vitro diag- HAVE BEEN to believe. Ultimately, the pharmacist B, List AF, Means RT, Paraskevas F, nostic devices. 2016; Public workshop Choose the proven partner in PT/INR testing. Only CoaguChek systems provide: AVOIDED. leaves the warfarin dose unchanged Rodgers GM, editors. Wintrobe’s - Point of care prothrombin time/ th and instructs the patient to return Clinical Hematology. 13 Ed. international normalized ratio devices A standardized solution with a single-strip platform. Count on consistent in 1 week for a follow-up INR. At Lippincott Williams & Wilkens; 2014. for monitoring warfarin therapy. results across the continuum of care. this follow-up visit, the patient’s p. 1241-1243. http://www.fda.gov/MedicalDevices/ POC INR is 2.9. Although she did 2. Heneghan C, Ward A, Perera R, et al. NewsEvents/WorkshopsConferences/ 97% correlation to the lab.2 Feel confident in therapeutic decisions with not suffer any harm, had a POC INR Self-monitoring of oral anticoagula- ucm476561.htm. (Accessed October correction factor been available and tion: Systematic review and meta- 15, 2016). lab-accurate data. applied, the patient’s inconvenience analysis of individual patient data. 3 and cost of follow-up INR could Lancet 2012;379:322-4. Stacy A. Johnson, MD, is the medical Heparin insensitivity. Focus on reducing heparin interference for more have been avoided. 3. Chaudhry R, Scheitel SM, Stroebel director of the University of Utah Health accurate results. RJ, et al. Patient satisfaction with Care thrombosis service and an assistant Conclusion point-of-care international normalized professor of POC INR testing for chronic antico- ratio testing and counseling in a com- medicine in the Learn more at go.roche.com/trusted agulation monitoring enables patient munity internal medicine practice. division of general self-testing and self-monitoring, and Manag Care Interface 2004;17:44-6. internal medicine is more convenient and ef cient than 4. Hur M, Kim H, Park CM, et al. at the University 1GHX Market Intelligence. Data on file at Roche Diagnostics. 297% correlation with lab results using Dade Innovin reagent on a Sysmex 560 Analyzer. CL INR testing. POC INR testing is Comparison of international normal- of Utah School of See CoaguChek XS PT Test Strip package insert for more information. widely used in outpatient labs and ized ratio measurement between Medicine. 3See CoaguChek® XS PT Test Strip package insert for more information. anticoagulation clinics, although CL CoaguChek XS Plus and STA-R +EMAIL: COAGUCHEK is a trademark of Roche. INR testing remains the reference coagulation analyzers. Biomed Res Int stacy.a.johnson@ © 2017 Roche. PP-US-10085-0317 standard. Laboratory professionals 2013;2013:213109. hsc.utah.edu

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