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NICE has recommended that adults and children taking chronic vitamin K antagonists, such as warfarin, for atrial fibrillation or heart valve disease could self-monitor their coagulation.

The guidelines recommend using the CoaguChek XS system or InRatio2 PT/INR monitor if the patient prefers self-testing and they (or their carer) is physically and cognitively able to self-monitor effectively.

According to NICE, “there is greater uncertainty of clinical benefit for the InRatio2 PT/INR monitor than for the Coagu- Chek XS system” but both monitors offer “precision and accuracy … comparable to laboratory-based INR [international normalised ratio] testing”. Patients and carers will need training in the effective use of their monitor, adds NICE, and clinicians should regularly review the ability to self-monitor.