JAMDA
Volume 8, Issue 6 , Pages 404-408 , July 2007

Measuring International Normalized Ratios in Long-Term Care: A Comparison of Commercial Laboratory and Point-of-Care Device Results

  • Daniel Bluestein, MD, MS, CMD, AGSF

      Affiliations

    • Department of Family and Community Medicine, Eastern Virginia Medical School, Norfolk, VA
    • Corresponding Author InformationAddress correspondence to Daniel Bluestein, MD, MS, CMD, AGSF, Department of Family and Community Medicine, Eastern Virginia Medical School, 721 Fairfax Avenue, Norfolk, VA 23507.
    • ,
  • Cynthia Brantley, MSN, GNP
    • ,
  • Myra Barnes-Eley, MPH

      Affiliations

    • Center for Pediatric Research, Eastern Virginia Medical School, Norfolk, VA
    • ,
  • Stefan Gravenstein, MD, MPH, CMD, AGSF

      Affiliations

    • Glennan Center for Geriatrics and Gerontology, Eastern Virginia Medical School, Norfolk, VA
    • ,
  • Sameh Basta, MD

      Affiliations

    • Sentara Health Care, Norfolk, VA.

References 

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  2. Weinberg AD, Altman JS, Pals JK. Quality improvement case study: Warfarin sodium interactions. J Am Med Dir Assoc. 2006;7:315–318
  3. Ansell J, Hirsh J, Poller L, Bussey H, Jacobson A, Hylek E. The pharmacology and management of the vitamin K antagonists: The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest. 2004;126(3 Suppl):204S–233S
  4. Sunderji R, Gin K, Shalansky K, et al. Clinical impact of point-of-care vs laboratory measurement of anticoagulation. Am J Clin Pathol. 2005;123(2):184–188
  5. Dorfman DM, Goonan EM, Boutilier MK, Jarolim P, Tanasijevica M, Goldhaber SZ. Point-of-care (POC) versus central laboratory instrumentation for monitoring oral anticoagulation. Vasc Med. 2005;10(1):23–27
  6. McBane RD, Felty CL, Hartgers ML, Chaudhry R, Beyer LK, Santrach PJ. Importance of device evaluation for point-of-care prothrombin time international normalized ratio testing programs. Mayo Clin Proc. 2005;80(2):181–186
  7. Poller L, Keown M, Chauhan N, et al. Reliability of international normalised ratios from two point of care test systems: Comparison with conventional methods. BMJ. 2003;327(7405):30
  8. Finck KM, Doetkott C, Miller DR. Clinical impact of interlaboratory variation in international normalized ratio determinations. Am J Health Syst Pharm. 2001;58(8):684–688
  9. Hobbs FD, Fitzmaurice DA, Murray ET, Holder R, Rose PE, Roper JL. Is the international normalised ratio (INR) reliable? (A trial of comparative measurements in hospital laboratory and primary care settings). J Clin Pathol. 1999;52(7):494–497
  10. Reed C, Rickman H. Accuracy of International Normalized Ratio determined by portable whole-blood coagulation monitor versus a central laboratory. Am J Health Syst Pharm. 1999;56(16):1619–1623
  11. Reiss RA, Haas CE, Griffis DL, Porter B, Tara MA. Point-of-care versus laboratory monitoring of patients receiving different anticoagulant therapies. Pharmacotherapy. 2002;22(6):677–685
  12. Jonsson M, Hillarp A, Svensson P. Comparison between CoaguChek S- and Owren-type prothrombin time assay for monitoring anticoagulant therapy. Thromb Res. 2004;114(2):83–89
  13. Eldor A, Schwartz J. Self-management of oral anticoagulants with a whole blood prothrombin-time monitor in elderly patients with atrial fibrillation. Pathophysiol Haemost Thromb. 2002;32(3):99–106
  14. Chapman DC, Stephens MA, Hamann GL, Bailey LE, Dorko CS. Accuracy, clinical correlation, and patient acceptance of two handheld prothrombin time monitoring devices in the ambulatory setting. Ann Pharmacother. 1999;33(7-8):775–780
  15. INRatio meter [product information]. San Jose, CA: HemoSense, Inc; 2003;
  16. Horton JD, Bushwick BM. Warfarin therapy: evolving strategies in anticoagulation. Am Fam Physician. 1999;59(3):635–646
  17. Crowther MA, Douketis JD, Schnurr T, et al. Oral vitamin K lowers the international normalized ratio more rapidly than subcutaneous vitamin K in the treatment of warfarin-associated coagulopathy: A randomized, controlled trial. Ann Intern Med. 2002;137:251–254
  18. Perry SL, Samsa GP, Ortel TL. Point-of-care testing of the international normalized ratio in patients with antiphospholipid antibodies. Thromb Haemost. 2005;94(6):1196–1202
  19. Quien ET, Morales E, Cisar LA, et al. Plasma tissue factor antigen levels in capillary whole blood and venous blood: Effect of tissue factor on prothrombin time. Am J Hematol. 1997;55(4):193–198
  20. Kitchen S. Problems in laboratory monitoring of heparin dosage. Br J Haematol. 2000;111(2):397–406

 Funding for this study was provided by AMDA Foundation/Pfizer Quality Improvement Awards to the first and second authors. The authors report no conflicts of interest

PII: S1525-8610(07)00170-3

doi: 10.1016/j.jamda.2007.02.006

JAMDA
Volume 8, Issue 6 , Pages 404-408 , July 2007

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