MOST health boards in Scotland do not know how many cardiac patients are using home self-testing machines that allow them to regulate their levels of the blood thinning drug warfarin.
Campaigners want to see the 80,000 people in Scotland who are prescribed warfarin given the opportunity to monitor their condition at home or work rather than making time-consuming visits to specialist clinics, saving the NHS millions annually. But self-testing is not an established practice, despite the government’s commitment to person-centred care and NHS backing.
The small portable self-testing devices cost around £250 and are often provided to patients by charities. Patients put a pin-prick of blood on a paper strip which allows the machine to monitor the effects of warfarin. They then email the reading to the clinic and receive a reply telling them how many tablets they need to take.
Some patients “self-manage”, meaning they are responsible for both readings and dosage.
Mary Hemphill, who suffers from a congenital heart condition, presented a petition to the Scottish Parliament earlier this year, along with fellow heart patient Ian Reid, calling for a national self-testing protocol.
Hemphill, 40, a bank manager from Port Glasgow, has analysed responses from 11 of Scotland’s 14 health boards aimed at giving an accurate picture of what services they offer warfarin patients.
The findings reveal only 209 people (0.37 per cent) were self-monitoring out of an estimated 55,498 warfarin patients in the boards’ catchment areas. It also emerged that nine out of the 11 health boards either did not know how many people self test or have rates of less than 1 per cent.
Hemphill, said: “These figures are really eye-watering. There appears to be no finance for machines despite the Scottish Government having a huge focus on a 20-20 vision where people’s health care is integrated and they receive some help at home.”
Christopher Allen, senior cardiac nurse at the British Heart Foundation, said self-testing can be more convenient if patients were trained and attend clinics to have their machine calibrated.
However, Allen added: “A disadvantage of self-testing could include patients underestimating instances where their INR [bloodtest measurement] is too high or too low and not seeking help or effectively managing this themselves.”
A Scottish Government spokeswoman said: “The guidelines on ‘self-testing’ are currently being reviewed by Healthcare Improvement Scotland, with a target date of October 2015 for publication.
“It is for boards to consider how best to progress discussions between patients and clinicians on the delivery of care.”