Additionally, the CoaguChek XS has been shown by the investigators to slightly underestimate the INR compared to the pathology method.[19] This was discussed in the training provided to nursing staff and GPs, and might have influenced the GPs’ dosing decisions if the INR was slightly below the target range. The duration of the intervention may also not have been of sufficient duration to demonstrate a significant change in the TTR compared to standard therapeutic ranges. The GPs, nurses and patients who were involved in the study and completed an evaluation questionnaire all found it to be a beneficial

service. The GPs’ individual PFT�� nmr opinions were divided, however, and this may have been due to the fact that each GP only had between one and three patients enrolled in the study, and their patients may have already been optimally managed and controlled. ACP-196 ic50 The neutral response to whether GPs would feel more confident

in managing patients taking warfarin if it was a regular service may have been due to some GPs already feeling confident in their management of warfarin therapy and not requiring additional help. Nurses gave positive responses to the use of the CoaguChek XS monitor: they strongly agreed that having access to a portable INR monitor would improve outcomes for patients taking warfarin. Despite the nurses agreeing that they had received adequate training in using the MedePOC computer program, perhaps pre-existing computer literacy selleck products affected confidence with its use. Patients were satisfied with their nursing home’s

involvement in the study, found it to be a worthwhile service and, importantly, would feel more confident about taking warfarin if this was a regular service. This is a significant factor when assessing compliance in those aged-care patients who manage their own medication. Most patients indicated that they would prefer a finger-prick blood test with a portable INR monitor to the usual pathology blood test. This finding is supported by a similar study.[16] All the patients agreed that their warfarin was better controlled during the study, probably because they were made more aware of their INR results with the weekly POC testing. The results of our study suggest that there remains scope for significant improvement in INR control in the aged-care setting; studies demonstrate that many TTRs approaching 70–80% can be achieved with the appropriate monitoring and communication/decision-support systems in place.[27] The INR control during the intervention phase demonstrated a tendency to maintain a low target INR for ACF residents: this could be a target for future studies given that outcomes may be better when a target slightly above rather than slightly below the therapeutic range is aimed for.