Warfarin Management News and Views

A Thrombotrack INR user’s meeting was recently held in Lincolnshire. The event was a great success and acted as a training update for community based teams and to provide a forum to discuss issues with experienced service providers along with experts from the laboratory and Axis-Shield. Some of the issues and conclusions reached are summarised here:

Summary

• Although the INR system was introduced to avoid inter laboratory discrepancies, patient results can vary depending on which system or reagents are employed. This has been hi-lighted by some recent changes in laboratory reagents.

• No one INR reagent can be considered a “Gold Standard”.  We don’t know who is right, and these variations are reflected in the NEQAS results.

• Testing should be on one system only; patients should be discouraged from chopping and changing methods.

• Anticoagulant managers (laboratory, hospital or community based) should work with their clinical colleagues e.g. cardiologists, to ensure that patient pathways incorporate these potential differences.

• Producing a local calibration or moving to alternative reagent systems can provide greater consistency between different testing sites.

• Thrombin inhibitors are on their way, but won’t be suitable for everyone e.g. unlikely to be licensed for patients with replacement heart valves. In the next 10 year or so, patients left on warfarin will probably be the difficult to dose patients and the ones whose INR needs to be kept at 3.5 – 4.5.

 If you would like to discuss any of these issues further or if you are interested in attending a similar event in future then please contact us at Axis Shield.

Written by admin
Filed under: Thrombotrack and Thrombotest - Related News