Asua J, Gutierrez-Ibarluzea I, Gutierrez Iglesias MA, Urquia Plazaola A, Rodriguez Canas N; International Society of Technology Assessment in Health Care. Meeting.

Annu Meet Int Soc Technol Assess Health Care Int Soc Technol Assess Health Care Meet. 2002; 18: abstract no. 13.

1Basque Office for Health Technology Assesment (Osteba), Donostia-San Sebastian, 1, Vitoria-Gasteiz, osteba1-san@ej-gv.es; osteba7-san@ej-gv.es; osteba3-san@ej-gv.es

BACKGROUND/OBJECTIVES: The use of oral anticoagulants has increased in the last years. In fact, we have observed an increase of 10% in the prothrombine tests performed the first six months of 2001 in the Basque Country meaning that 1-3% of the total population of our autonomous region followed oral anticoagulation therapy (OAT). The International Normalised Ratio (INR) is a good reference for the control of OAT. That control has been previously released by specialised units or laboratories. Nowadays there are portable devices for blood testing that calculate the INR from capillary blood. Aim: This report try to determine the efficiency of the portable coagulometers in the control of patients following OAT in hospitals and primary care units. METHODS: We firstly performed a systematic review of the literature, then we summoned a consensus group including haematologists, primary care physicians, nurses and policy makers. Finally, we obtained data from two pilot studies, using portable coagulometers instead of laboratory tests: a Primary Care experience and a Hospital one. RESULTS: The scientific evidence showed that portable coagulometers have good levels of precision that match those obtained in specialised laboratories (80-90%) and were better when portable devices were used by trained sanitary staff. The patient's preferred digital puncture instead of vein puncture. The pilot studies proved that the portable devices are efficient in OAT control in the case of patients with stable anticoagulation (INR: 2-4) both in the primary care and hospital experiences (69% and 65% of the patients within range, respectively). We also obtained data about the mean cost of laboratory analysis and portable devices being 4,33 [EUR] and 2,28 [EUR] , respectively. DISCUSSION: Taking into account a similar effectiveness and a minor cost of the analysis performed by portable devices, we can conclude that is a cost-effective technique. Finally, we propose: centralised laboratory tests in case of patients with unstable OAT, primary care or hospital controls (using portable devices) performed by trained sanitary staff, supported by decision algorithms in case of patients with stable OAT and guarantor controls in specialised laboratories and haematological services to ensure the effectiveness.

Publication Types:

• Meeting Abstracts

Keywords:

• Anticoagulants
• Case-Control Studies
• Costs and Cost Analysis
• Hospitals
• Humans
• International Normalized Ratio
• Laboratories
• Laboratories, Hospital
• Pilot Projects
• Primary Health Care
• economics
• hsrmtgs

Other ID:

• GWHSR0002950

UI: 102274629

From Meeting Abstracts