Grace da Silva from London is living proof that people on long term anticoagulation therapy for atrial fibrillation (AF) can manage their condition themselves successfully, if they have the right technology and professional support.
She is just one of thousands of patients with AF (or irregular heartbeat) who are being encouraged to self-monitor, with the help of a unique package of education, support and software from Helicon Health. It follows recent new guidelines from NICE (National Institute for Health and Care Excellence). NICE says greater use of self-monitoring is likely to reduce heart attacks and strokes caused by blood clots.
Grace, from Crouch End, was diagnosed with AF over 20 years ago. She was prescribed anticoagulants and had to attend her local hospital regularly for blood tests to check she was on the optimal dose. Then she had a pacemaker fitted, which made a significant difference to her quality of life. Life got even better when her partner gave her a CoaguChek, one of the self-monitoring devices recommended by NICE.
With advice and support from her anticoagulation clinic to get her started, Grace was soon self-monitoring, and she has never looked back.
Her blood test, which now takes about two minutes, used to be a huge upheaval every six weeks. She would have to wait for public transport, as parking at the hospital was difficult, and then endure a 40 minute journey each way. On top of this she would often have to sit in hospital waiting rooms, where she was at risk of infection – not a good environment for someone with Grace’s health issues.
She explains: “Now that I self-test, it only takes a couple of minutes in the comfort of my own home. I can continue with my daily life, without worrying about hospital appointments. I no longer have to plan my holiday or days out around my blood test appointments as I can take my CoaguChek with me, and more importantly I play an active role in my treatment and find I worry less about my AF.”
The CoaguChek works by monitoring blood clotting time by using a measure known as the international normalised ratio (INR). Grace does a simple finger prick test, and calls in the results which are uploaded to her HeliconHeart electronic health record for her doctor to review. The anticoagulant dosage and the planned next INR test can then be adjusted as required.
Helicon Health founder David Patterson, who is emeritus professor of cardiovascular medicine at University College London, said:
“Research has shown that this approach of identifying people with AF and treating them with oral anticoagulants can reduce preventable strokes and save money. Indeed, many patents actually control their INR results better when they self-test than the health care professional can.
In one clinical commissioning group in North London, it is estimated to have prevented 37 strokes per annum among an over-60 population of 57,290, saving an estimated £592,000 in stroke care.”