Patient organisation comments

Advice

Key benefits for patients identified by patient organisations included the practical impact on people in reducing time needed visiting clinics, minimised trauma using capillary testing and the speed and accuracy of results to inform their individual management. Two organisations also highlighted the known benefits of self-management in empowering people to take responsibility for their health. This can improve adherence to medicine regimes, offer an increased likelihood of staying within the therapeutic range, improve quality of life and better manage the condition to reduce the risk of atrial fibrillation-related stroke.

Patient organisations noted that those who could particularly benefit from the technology were those who needed frequent monitoring as well as those who have difficulty attending clinics, either because of reliance on family or hospital transport to travel or because of educational or work commitments. Also, 1 organisation suggested a benefit to those who are needle phobic and are attending for venous samples. Another organisation highlighted care home residents (being at particular risk of bleeding and clotting) would benefit from the timely and less-invasive capillary testing using point-of-care machines.

All 3 organisations highlighted that individuals considered for self-testing would need to be physically and cognitively capable of performing and following instructions for the procedure and action of the test independently, or a family member or carer trained to assist with testing regime.

Two organisations highlighted that because guidance now recommends that where appropriate direct oral anticoagulants should be offered (rather than warfarin), this may result in less people needing regular monitoring and be a potential obstacle in the adoption of the device. Two organisations highlighted that despite guidance supporting the use of point-of-care international normalised ratio (INR) monitors and the broader goal across the NHS to encourage self-management, provision of self-monitoring options continues to be varied, based on local clinical commissioning group decision making. One organisation stated that devices are often being self-funded by users, making affordability an important barrier alongside support for training, calibration and access to test strips affecting implementation. One organisation highlighted the challenge of only 1 device currently being supported in guidance and the importance of increasing availability and choice of devices to maximise reach to this population.