Coagulation self-management
With coagulation self-management (also INR self-measurement ), the dosage of certain medically prescribed drugs to inhibit human blood coagulation is not done by a doctor, as in most cases, but by the patient himself. To do this, he or she must independently perform a quick test to determine the INR value (out of date " Quick value "). The INR value is a laboratory-determined parameter that allows conclusions to be drawn about the functional performance of the blood coagulation system in the body. The measured value determines the next drug dose so that a target value specified by the doctor is achieved if possible. Coagulation self-management is a safe option for patients who agree to the procedure, whose doctor supports them, who are able to carry out all steps and who can be trained by medical specialists, to control therapy with anticoagulant tablets.
Oral anticoagulation
The technical term for anticoagulant is "anticoagulation". Anticoagulants in tablet form are therefore also called "oral anticoagulants". Only some specific oral anticoagulants require close control by the doctor or by clotting self-management. For example, in some cases after the implantation of an artificial heart valve or in the case of the arrhythmia atrial fibrillation . Patients may then be treated by their doctor with a special group of anti-clotting drugs, the coumarins (also known as vitamin K antagonists ). The dose determination of coumarins is usually based on the measured INR value. In the case of lifelong therapy, this value must be measured at intervals by the doctor or by the patient as part of self-coagulation management.
Measurement method
Small, portable and battery-operated measuring devices are used to measure the INR value. A briefing by medical specialists is a prerequisite for independent operation. The process of measuring is comparable to measuring blood sugar with a blood glucose meter . A drop of capillary blood is placed on a test strip . To obtain blood, the skin is punctured with a lancet. After the blood has been taken up in the measuring device, a measured value is determined and displayed in a short time.
Drug dosage
Based on the measured value, the patient is responsible for determining the dosage of the anticoagulant drug. The INR target range is determined by the attending physician. Precise documentation should be provided.
Web links
Individual evidence
- ^ Carl Heneghan, Alison Ward, et al. a .: Self-monitoring of oral anticoagulation: systematic review and meta-analysis of individual patient data . In: The Lancet . tape 379 , no. 9813 , January 2012, p. 322 , doi : 10.1016 / S0140-6736 (11) 61294-4 , PMID 22137798 .
- ↑ Josep M Garcia-Alamino, Alison M Ward, u. a .: Self-monitoring and self-management of oral anticoagulation . In: Sao Paulo Medical Journal . tape 128 , no. 4 , July 2010, p. 246 , doi : 10.1590 / S1516-31802010000400015 , PMID 20393937 .
