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NICE issues draft guidance on coagulation testing device

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The National Institute for Health and Care Excellence has published recommendations for self-monitoring the clotting of blood in people on long-term anticoagulation therapy.

The draft guidance, which has been issued for public consultation, supports the use of the Coaguchek XS system for those with atrial fibrillation or heart valve disease as a means of self-monitoring the time it takes for their blood to clot.

This comprises a meter and specifically designed test strips that can analyse a blood sample and calculate the prothrombin time (PT) and the international normalised ratio (INR).

The latter of the two is an important measure because it enables the dose of anticoagulant to be adjusted if required, thereby avoiding adverse events that can result from an over- or under-dose, such as major bleeding or stroke.

“People on long-term anticoagulation need to monitor their blood regularly to make sure they are taking the appropriate dose of their drug,” said Professor Carole Longson, director of the NICE Health Technology Evaluation Centre.

“The time and cost of attending an anticoagulation clinic can be a significant burden for people on long-term oral anticoagulation therapy and can impact significantly on both their working life and family life,” she said. “These point-of-care tests can potentially reduce that impact.”

Self-monitoring, which involves either self-testing or self-managing, can enable patients to be monitored more regularly. This may improve health outcomes for patients by allowing the dose of therapy to be adjusted more accurately.

The most common anticoagulant medicines are heparin and warfarin.


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