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CAR/WED/01 ANTICOAGULATION AT HOME: THE WAY FORWARD

A Upponi, A Rakhecha, D Bhat, MEC Blackburn. Leeds Genaral Infirmary, Leeds, UK

Introduction: An increasing number of children with heart conditions requiring long-term anticoagulation are being monitored by home international normalised ratio (INR) testing in the United Kingdom for its convenience and cost-effectiveness. There is, however, a paucity of data on the effectiveness of home testing in achieving satisfactory anticoagulation when used alone without hospital-based testing.

Aim: To assess objectively the effectiveness, extent of adverse reactions and user satisfaction with home INR testing when used alone to monitor control in children on warfarin.

Methods: A retrospective record-based study supplemented with a telephone survey to assess user satisfaction conducted at a referral paediatric cardiology unit over one year (April 2006 to April 2007). Records of 41 children monitored by home testing and advised by unit-based doctors for dose adjustment were analyzed.

Results: Anticoagulation control was studied over a cumulative period of 14 965 days during which the INR remained within the therapeutic range for 57% of the time and was out of the safe range (>1 of target value) for 9% of the time. High values of greater than 8 and greater than 5 appeared on 6 and 150 days, respectively. Patients required heparin on six occasions and there were no reports of haemorrhage or other adverse symptoms. An underlying diagnosis of mitral valve replacement was significantly higher among patients with worst INR control. Parents were found to be highly satisfied with all aspects of the service except for consistency of advice.

Conclusion: With a well-organised training programme and doctor-led dose adjustment service, home-based INR testing is a safe and effective alternative to hospital-based monitoring with an overall high level of user satisfaction.

CAR/WED/02 INVESTIGATION AND REPAIR OF TETRALOGY OF FALLOT: CURRENT UK PRACTICE

A Upponi, A Rakhecha, D Bhat, V Acharya, J Thomson. Leeds General Infirmary, Leeds, UK

Introduction: Tetralogy …

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