Abstract:
Introduction: Patient self-testing International Normalized Ratio (INR) is a patient or caregiver performing the blood sampling and testing using point of care testing (POCT), while the healthcare provider will decide the patient’s warfarin dose and the next testing date. Studies showed that self-testing INR improved time within the therapeutic range (TTR), patient satisfaction and quality of life. Although patient self-testing INR has been proven beneficial, there is a need to understand the applicability in the local Malaysian population. This study aims to obtain insights, from Malaysian stakeholders towards patient self-testing INR.
Methods: This is a qualitative study using a semi-structured interview guide. Participants are stakeholders with at least one year of experience in warfarin treatment. All individual interviews were audio-recorded and transcribed verbatim. The thematic inductive method was used to analyse the data.
Results: The study involved 17 participants with only one healthcare provider has experience managing patient self-testing INR. The findings on perceived benefit and barrier on self-testing were consistent with studies reported. Barriers hindering and solutions proposed have to be given thoughtful considerations for successful implementation. INR monitoring in Malaysia has a potential to be decentralized from public tertiary care to primary care with the involvement of public health clinic, General Practitioners and community pharmacists in future. This is a single centre study. The findings shall be used for future quantitative studies involving more participants in more centres to better represent the general population.
Conclusion: The findings of this study indicated that stakeholders welcome self-testing INR in patients on long term warfarin and think it is feasible.
Keywords: INR; self-testing; stakeholders; point of view; Malaysia
