Mobile remote monitoring with point-of-care testing improved time to therapeutic anticoagulation (P<0.01), time in therapeutic range (P<0.05), and reduced complications (P<0.05) vs standard care.
Cross-Sectional (n=148)
No
Does mobile remote monitoring combined with point-of-care testing improve anticoagulation outcomes, safety, and satisfaction in postoperative cardiac valve replacement patients receiving warfarin compared to conventional management?
Combining mobile remote monitoring with point-of-care testing for warfarin management in post-valve replacement patients significantly improves time in therapeutic range, reduces complications, and lowers costs compared to conventional hospital-based monitoring.
Lifelong anticoagulation monitoring is essential for mechanical heart valve recipients. While conventional hospital-based monitoring creates significant patient and system burdens, combining mobile remote monitoring (MRM) with point-of-care testing (POCT) may provide a more efficient solution. This study evaluated whether MRM + POCT enhances warfarin therapy quality and patient outcomes. This study compared conventional anticoagulation management versus MRM + POCT in 148 post-valve replacement patients (74 per group). The conventional cohort underwent standard in-hospital testing and received anticoagulation management guidance from outpatient clinic physicians. In contrast, the MRM + POCT group utilized POCT for self-monitoring, with anticoagulation therapy guided remotely by physicians via the MRM system. We assessed prothrombin time/international normalized ratio values, time to therapeutic anticoagulation, time in the therapeutic range, costs, complications, and satisfaction over 12 months. Compared with conventional anticoagulation management, MRM + POCT resulted in superior outcomes: Faster therapeutic anticoagulation ( P < .01), a greater time in the therapeutic range ( P < .05), fewer complications ( P < .05), lower costs ( P < .01), and better satisfaction ( P < .01), demonstrating improved clinical and patient-centered outcomes. Additionally, both clinicians and patients found the integrated system user-friendly, easy to master, and expressed a strong intention to continue its use. MRM + POCT optimizes warfarin therapy by improving efficacy, safety, and cost-effectiveness while enhancing patient outcomes, supporting its implementation as standard care for remote anticoagulation management.
Huang et al. (Fri,) conducted a cross-sectional in Postoperative cardiac valve replacement receiving warfarin therapy (n=148). Mobile remote monitoring (MRM) combined with point-of-care testing (POCT) vs. Conventional hospital-based anticoagulation management was evaluated on Time to therapeutic anticoagulation, time in the therapeutic range, costs, complications, and satisfaction. Mobile remote monitoring with point-of-care testing improved time to therapeutic anticoagulation (P<0.01), time in therapeutic range (P<0.05), and reduced complications (P<0.05) vs standard care.