Patient Self-Testing

How it works

Benefits

Comparisons

Background

Evidence quality

Highlighted claims

• Patient self-testing has patients measure their own INR at home using a POCT device while a clinician or pharmacist retains responsibility for dose adjustment. — Evaluation of a pharmacist-led patient-self-testing model for warfarin management in patients undergoing mechanical heart valve replacement in China: a multicentre, open-label, randomised, controlled trial
• Patient self-management extends beyond PST by having patients control both monitoring and dosing decisions. — Evaluation of a pharmacist-led patient-self-testing model for warfarin management in patients undergoing mechanical heart valve replacement in China: a multicentre, open-label, randomised, controlled trial
• No multicentre RCT had evaluated PST in China or any other low- or middle-income country before this study. — Evaluation of a pharmacist-led patient-self-testing model for warfarin management in patients undergoing mechanical heart valve replacement in China: a multicentre, open-label, randomised, controlled trial
• PST patients performing 41 INR tests per person-year versus 8 in usual care experience shorter periods of subtherapeutic or supratherapeutic anticoagulation. — Evaluation of a pharmacist-led patient-self-testing model for warfarin management in patients undergoing mechanical heart valve replacement in China: a multicentre, open-label, randomised, controlled trial
• PST effectively reduced both major haemorrhagic and thromboembolic complications compared with usual care. — Evaluation of a pharmacist-led patient-self-testing model for warfarin management in patients undergoing mechanical heart valve replacement in China: a multicentre, open-label, randomised, controlled trial
• The primary mechanism linking PST to improved clinical outcomes runs through testing frequency enabling earlier out-of-range detection and faster dose correction. — Evaluation of a pharmacist-led patient-self-testing model for warfarin management in patients undergoing mechanical heart valve replacement in China: a multicentre, open-label, randomised, controlled trial
• Meta-analyses show both PST and PSM improve TTR, but only PSM had previously demonstrated improvement in thromboembolic outcomes. — Evaluation of a pharmacist-led patient-self-testing model for warfarin management in patients undergoing mechanical heart valve replacement in China: a multicentre, open-label, randomised, controlled trial
• Prior RCTs that found no adverse event benefit for PST were limited because usual care control arms already achieved TTR above 60%, leaving little room for PST to show additional benefit. — Evaluation of a pharmacist-led patient-self-testing model for warfarin management in patients undergoing mechanical heart valve replacement in China: a multicentre, open-label, randomised, controlled trial