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Related Experiment Videos

Potential dosing errors using portable prothrombin time monitoring devices.

Ronen Loebstein1, Daniel Kurnik, Aharon Lubetsky

  • 1Institute of Clinical Pharmacology and Toxicology, The Chaim Sheba Medical Center, Tel Hashomer, Israel.

Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis
|July 10, 2003
PubMed
Summary

The Coaguchek S portable monitor accurately measures International Normalized Ratio (INR) for warfarin therapy control, unlike the Hemochron Jr, which can lead to dosing errors. This study highlights the importance of monitor choice for safe and effective anticoagulation management.

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Area of Science:

  • Medical Devices
  • Clinical Chemistry
  • Pharmacology

Background:

  • Portable prothrombin time (PT) monitors are used for warfarin therapy management.
  • Limited research compares the impact of different portable PT monitors on warfarin dosage decisions.

Purpose of the Study:

  • To compare the accuracy of two portable PT monitors, Coaguchek S and Hemochron Jr, against a reference laboratory.
  • To assess the influence of these monitors on warfarin dosage adjustments.

Main Methods:

  • 193 patients on warfarin underwent simultaneous International Normalized Ratio (INR) measurements using Coaguchek S, Hemochron Jr, and a reference laboratory.
  • Agreement was evaluated using regression analysis and pre-defined clinical criteria for dosage decisions.

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Main Results:

  • Coaguchek S showed good agreement with the laboratory (r² = 0.88), while Hemochron Jr did not (r² = 0.61).
  • 90% of Coaguchek S measurements met clinical agreement criteria versus 62% for Hemochron Jr (P < 0.0001).
  • Hemochron Jr led to unjustified dose increments in 22% of patients compared to 8% with Coaguchek S (P = 0.035).

Conclusions:

  • Coaguchek S provides reliable INR measurements comparable to laboratory standards for warfarin management.
  • Hemochron Jr measurements can lead to different and potentially incorrect warfarin dosage adjustments, especially at higher INR values.
  • Monitor selection is critical for accurate anticoagulation monitoring and patient safety.