K.X. ONG1, S.E.LOPEZ1, T. C. H. CHOO1, K. K. KNG1
Tan Tock Seng Hospital1
Warfarin has a narrow therapeutic index requiring frequent INR checks to ensure safety and efficacy of therapy. INR Remote Monitoring Service has been set up to allow patients greater convenience. The Service includes self-checking of loaned Point-of-care testing home INR meters, followed by pharmacist-led teleconsultation for warfarin dose adjustment. Due to COVID-19, our service has expanded to conduct out-of-hospital INR test to be done at Outpatient Polyclinic (BOPS) in efforts towards teleconsultation. The aim of the project is to evaluate efficacy of BOPS compared to self-check INR and regular clinic visit.
Patients, who met respective inclusion criteria, were recruited under self-check or BOPS group. Preliminary data from Nov 2020 – Jan 2021 were collected. Percentage of consults with INR within 0.5 of INR target was analyzed and compared to existing services.
60.6 % of INR results of patients under Remote Monitoring Service were within 0.5 of target as compared to 59.7% in conventional clinic visits. Under self-check and BOPS group, 52.9% and 71.4% of the INR results were within 0.5 of target respectively.
BOPS is likely to be as effective as the established self-check group and face-to-face clinic consults. It brings convenience to patients but pharmacists/physicians will not be able to perform physical examination of any complaints. Selection of appropriate patients is crucial to the success of this service. Limitation of this project is the small number of patients under Remote Monitoring Service. Further study over a longer period of time will need to be carried out.