CoagMax® – Professional Use

Benefits of self-testing
Self-monitoring / self-testing is the name given to the methods used by patients to test their own INR. The technology available for self-testing has improved greatly in recent years and results generally follow those generated by the laboratory. Dosing adjustments are still carried out by a qualified physician, but patients can often avoid unnecessary visits to see the doctor.

In 2006, a paper published in the Lancet reviewed many different clinical studies from around the world, showed significantly fewer negative outcomes and an improved quality of life inpatients self testing on oral anticoagulation therapy than those who self-tested as compared to those who were tested by conventional laboratory/clinic means. The benefits of moving from having a venous sample taken to finger stick sample plus having a reduced need to spend time in a clinic has resulted in more people on long-term OAT choosing self-testing.

The CoagMax® instrument using Smart Strip technology allows you to self-test in a significantly easier and less painful manner than ever before. Taking our cues from the blood glucose testing industry, we have designed a system with the patient in mind that allows the patient to take the meter to their finger rather than having to manipulate their finger towards the meter.

The Lancet review was updated in 2011 and showed again:
Reduction of adverse events in patients who self monitor their oral coagulation as compared to “usual care”

Reduction in Thromboembolic events – 50%
Reduction in Major Haemorrhagic events 12%
Reduction in Death – 18%
<55 yrs 67% reduction in thrombotic events Mech Heart Valve – 48% reduction in thrombotic events Reduction of adverse events

Reference: The Lancet Dec 2011 Heneghan, Ward, Perera ‘Self-monitoring of oral anticoagulation:systematic review and meta analysis of
individual patient data’

Point-of-care testing
There are several key benefits to point-of-care testing:

  • Compliance – Ability to discuss a patient’s INR with them in real time ensures you can positively reinforce any compliance issue face-to -face with the result in front of you.
  • Workflow – a fingerstick test is quick to perform – providing results within 3 minutes.
  • Flexibility – For patients requiring testing in the community, the CoagMax® is a small meter with its own carrying case that can be taken to the patient. Test results can be easilyadded to the patient record when back at the physician’s office.
  • Quality control – The strip has built-in quality checks to ensure the test strip is in premium condition for testing. Users can also run external liquid quality control and EQAsamples to ensure absolute integrity of the system and results.
  • Accessibility – Regular Point of Care INR testing can improve control, reduce the concerns about risk, and allow a greater percentage of AF patients to be moved to OAT.
Optimising therapy
The advent of new oral anticoagulants has resulted in much being said about how much time patients currently on Warfarin spend in the therapeutic range (TTR). The more time a patient spends in the therapeutic range the better the outcomes and the fewer adverse events. In a recent meta-analysis of 47 relevant studies, TTR significantly correlated with the rate of adverse events such as strokes.
How can you improve your therapeutic range (TTR)?
  • Firstly, it has been shown that when the applicable clinical guidelines are followed, TTR is markedly increased.
  • The move to more regular testing and patient self-testing has been shown in many clinical studies to improve TTR
  • Computer based dosing algorithms have also been shown to improve TTR
  • Face-to-face conversations about dosing will often improve compliance, which is also linked to improved TTR

In the UK it was found that a 5% improvement in average TTR could result in 550 fewer strokes per year, saving on average £12,000 per stroke event. – Connolly S. et al, on behalf of the ACTIVE W Investigators (2008) “Benefit of Oral Anticoagulant over Antiplatelet Therapy in Atrial Fibrillation Depends on the Quality of International Normalized Ratio Control Achieved by Centers and Countries as Measured by Time in Therapeutic Range” Circulation 118, 2029-2037