Use of point-of care devices in patients with oral anticoagulation: a Health Technology Assessment

Many patients take oral anticoagulants, usually for very long periods or even lifelong. This treatment improves life expectancy and reduces the risk of thromboembolic events but requires a close and inconvenient monitoring. Indeed, various factors such as diet or concomitant medications can affect the action of the anticoagulant. Doses should therefore be regularly adapted to prevent either the formation of clots or bleeding. These patients are therefore subject to frequent blood samples obtained by venous puncture, at least monthly, to ensure an appropriate level of oral anticoagulant therapy. This monitoring consumes time and money. Moreover, few people like regular blood sample. The recent emergence of portable coagulometers (point of care systems) usable anywhere, either by the physician or by the patient himself, could significantly reduce the hardness of this monitoring. However, before widely using such an instrument, it is necessary to verify its technical value, diagnostic accuracy and benefits for the patient. The potential use of point of care systems by the patients also requires a reflection on the evolution of the organizational model of care that this use could entailed. Finally, the budgetary impact of their use should also be taken into consideration. All these issues are addressed by this report, wholly conducted within the KCE. As usually, this report is also subjected to critical evaluation by external experts, with many thanks.

Tags: coagulometer
Year: 2009