Journal of Pharmacy Management - Jan 2022

Criteria Satisfactory manual dexterity i.e. no existing conditions which would prevent safe and effective use of Coaguchek® meter e.g. rheumatoid arthritis Active Telephone, mobile and/or live email address Access to internet/DVD player to obtain self- learning material Ability to understand self-learning material Satisfactory eye-sight – ability to read digital display Not eligible for DOAC switching Satisfactory DNA record (Not more than 2 DNAs in last 6 months) Excellent DNA record (No DNAs in last 6 months) Patient request/expression of interest for Coaguchek® Self-Testing Age ≤ 70 Age 71- 85 Maximum dosing interval in last 3 months (≤2 weeks) Maximum dosing interval in last 3 months (≤ 4 weeks) Scoring (1-2)/Mandatory (M) M M M M M M M 1 2 2 1 2 1 Journal of Pharmacy Management • Volume 38 • Issue 1 • January 2022 Figure 1. Royal Brompton and Harefield Hospitals Triage tool initiation and required an alternative solution for safe anticoagulation therapy monitoring. We identified that further expansion of our self-testing scheme could be a viable option for these patients. More anticoagulation clinics are supporting patients switching to INR self-testing, and the National Institute for Health and Care Excellence has advocated self-testing for patients on long-term vitamin K antagonist therapy. 6 This method of monitoring has been shown to improve patient satisfaction, adherence to therapy and overall anticoagulation control. 7 Through successful business planning and engagement with hospital general service managers, funding was secured for 50 self-testing machines. Due to limited and finite resources, we designed an internal triage tool to standardise the allocation of self-testing machines to those patients who were likely to benefit most from the scheme. The tool included mandatory criteria which would be a pre-requisite for patients to be able to safely engage with the scheme, in combination with scoring criteria which enabled us to rank patients according to those at greater risk of exposure to COVID-19, and those more likely to adhere to the programme (see figure 1). These criteria were adapted from local policies and subsequently tailored to the demographic of patients within our clinics. 8 Patients who reached a threshold score of 5 points, were put forward for enrolment onto the scheme. Following funding approval from the Trust, we were tasked with procuring the self-monitoringmachines at a time where such devices were in high demand. We liaised directly with the manufacturer Roche and were able to source the Coaguchek® XS devices within 2 weeks, which facilitated prompt rollout of the scheme. An important part of ensuring that patients safely enrolled on the programme, was through continuous patient education and support. Historically, training 7