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Dr. Mark Crowther and pharmacy owner James Dumont hope patients on blood-thinners can improve their health through faster, easier monitoring of their condition.

Inconvenience can lead to disease or death. Some 209,000 Canadians in publicly-funded drug programs depend on oral anticoagulation therapy to prevent blood clots, stroke and death.¹  The inconvenience of monitoring their condition means many patients "stretch" the time between testing and expose themselves to greater risk of health complications.  Now, however, there is an easier, more convenient way to test their blood - and it has the potential to save lives.

"Medical evidence suggests that more intensive coagulation monitoring using a device improves the quality of anticoagulant care and can thus reduce deaths and serious side-effects such as stroke," says Dr. Mark Crowther, Professor of Medicine and Chair of the Division of Haemotology at McMaster University.

Patients on long-term oral anti-coagulation therapy must have their blood tested regularly to ensure the medication is working properly and the dosage is correct.  Typically, this involves a trip to a local testing centre where a vial of blood is drawn for analysis.  Most patients should have their blood checked every two to four weeks.  However, the inconvenience involved for the patient and the limited capacity of the healthcare system to do long-term monitoring often mean testing is done much less often.

Because of the inconvenience involved, many patients "stretch" the time between tests, potentially leaving themselves improperly dosed for longer periods.  This can lead to serious health events such as uncontrolled bleeding, blood clots and strokes that may threaten their lives and require costly critical care.

New technologies have produced an alternative solution that makes it possible for patients to have their blood tested quickly: right in their doctor's offices, at special clinics, in pharmacies, or even at home.  Handheld Portable Anticoagulation Monitors operate in a similar fashion to blood glucose meters, which have long been used by diabetic patients to check their blood sugar.

The strip is inserted into the handheld Monitor: the patients prick their finger to produce a drop of blood, which is then applied onto the test strip. The monitor analyzes the "prothrombin" time - the speed at which blood clots - and displays a score in the form of an International Normalized Ratio (INR).  Results are almost immediate.  In consultation with a healthcare professional, patients can see immediately if their blood is within the target range and adjust their anticoagulation therapy if necessary.

Portable Anticoagulation Monitors are now being used in anticoagulation clinics, doctor's offices and over 1,000 pharmacies across Canada.  Many patients have also been trained to use the devices at home.  The result is improved patient satisfaction and better compliance with testing regimes.

"This practice enhances the quality of life of patients and allows for more flexibility," says James Dumont, owner of White Cross Dispensary in Ottawa.  "Testing in a pharmacy allows patients to quickly check their coagulation level if bleeding or dizzy spells occur."

Clinical evidence also suggests the use of Portable Anticoagulation Monitors results in better international normalized ratio control than traditional laboratory-based testing, fewer adverse health events such as haemorrhage and/or clots and fewer deaths.^2,3

Technology Overview

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