Having worked in LTC for the past 5 years… I routinely deal with PT/INR’s at a distance… recommend INR’s being done with a pt’s therapy is changed and it is going to have a impact on the pt’s INR in the short term. A week ago my wife ended up in ER – via a doc-in-a-box visit & ambulance ride – because she was too stubborn to go directly to the hospital.. after nearly a 5 day hospitalization, she was dxed with A-Fib, Congestive heart failure. Her PCP said that because she had a right mastectomy she could not have blood drawn in that arm and the left arm veins are pretty well shot because of the chemotherapy she received years ago.. So … he was going to put her on Pradaxa .. My wife is on a “ton” of medication because of her other health issues and I knew that Pradaxa’s only antidote was dialysis & frozen blood plasma. That is fine and well.. if we always stayed within our local community and know where services/care is available… but.. we travel a fair amount…
She has not yet returned to sinus rhythm .. and apparently they are going to “shock” her in a few weeks if she doesn’t revert… Needless to say.. if she does not revert.. I am not comfortable with her being on Pradaxa long term..
So I started looking into alternatives to having to draw blood and having her on a drug that has very limited antidote… Did a simple web search and found..
And their website http://www.advancedcardioservices.com/products/
They have a blood glucose type testing system.. to do weekly INR”s with just a FINGER STICK… which is paid for by Medicare.. after the pt is on Warfarin for 90 days…While this is not going to be a valid answer for every pt… but just think of the number of pts that may still be working and having to take off work to go to the lab/doc’s .. to get INR’s ran… or has trouble with a venous puncture being done… the number of the pts that the community Pharmacist sees every day that this could benefit… is numerous…The company claims a 98% accuracy. They also have a video on their website that demonstrates the testing procedure using their meter and strips. Once the pt does the test.. they have the option to report the results via phone or website… which is then sent to the pt’s doc.
The company sells the meter and supplies directly to the pt, sends someone to train the pt… and bills Medicare/Insurance and does all followup with the pt and their weekly testing, and the pt’s doctor has to order the testing system for the insurance to pay… This provides the RPH with a simple referral to help their pts to better and more easily manage their Warfarin therapy.
Filed under: General Problems
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Yes, sounds like a great device!
I have known about this for quite a while! At my request my mothers cardiologist set her up with this company/system several years ago now. She has lost vision in one eye from a clot and driving is more difficult for her. It made sense for her to test at home. It has worked well. One thing I will tell you is that there may be times she uses more than one cassette a week for the test for various reasons and she may need to pay out of pocket for the extras. Fairly priced though. May your wife’s afib return to normal sinus rhythm.
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Steve: Only 3% of all Medicare Part B denials are appealed… yet over 50% of the appealed claims are approved for payment. While the cost per test is $25-$30… it is cost effective to going to a lab and/or doc’s office to get a test done. Winning one appeal should make it quite easy to win further appeals.
Love this idea!! I think I will send the link to an in law of mine who was just in the hospital with clots in her lungs because her INR got below desired levels.