Patient self-testing of prothrombin time after hip arthroplasty

Area of Science:

• Orthopedics
• Medical Devices
• Pharmacology

Background:

• Anticoagulation prophylaxis is crucial after total hip arthroplasty (THA).
• Monitoring prothrombin time (PT) ensures therapeutic anticoagulation and minimizes bleeding risks.
• Current monitoring often involves standard venipuncture and laboratory analysis.

Purpose of the Study:

• To evaluate the reliability and cost-effectiveness of patient self-testing of prothrombin time (PT) using a portable device.
• To compare self-testing with the standard protocol involving home health-care nurses for anticoagulation management post-THA.
• To assess the impact of self-testing on the quality of care in elderly THA patients.

Main Methods:

• Forty-six total hip arthroplasty patients were enrolled in the study.
• A subset of patients were trained to use a portable device for self-monitoring prothrombin time over six weeks.
• Results were compared with a matched control group managed via standard venipuncture and home health-care nurse monitoring.

Main Results:

• While 15% of patients could not be trained for self-sampling, 29 patients completed the study.
• Self-testing demonstrated high reliability when compared to results from the standard venipuncture protocol.
• Patient self-testing resulted in cost savings of approximately $260 per patient compared to venipuncture.

Conclusions:

• Patient self-testing of prothrombin time using a portable device is a reliable method for monitoring anticoagulation status after total hip arthroplasty.
• This self-testing approach is cost-effective, offering significant savings over traditional venipuncture.
• Self-testing is suitable for a select group of elderly patients undergoing THA, potentially improving care efficiency.