Tools and resources

1 Introduction

1 Introduction

Published date: February 2015 Last updated: June 2018. See update information for a summary of the changes.

This resource has been developed to provide practical information and advice on self-monitoring coagulation status using a point-of-care coagulometer (the CoaguChek XS system) for people having treatment for atrial fibrillation and heart valve disease with a vitamin K antagonist, as recommended in the NICE diagnostics guidance on atrial fibrillation and heart valve disease: self-monitoring coagulation status using point-of-care coagulometers.

It is intended for use by both clinical and non-clinical staff who are planning to implement this NICE guidance and start using this technology.

NICE's Adoption team worked with NHS organisations to share their learning and experiences of using CoaguChek XS for self-monitoring of coagulation status. The information presented in this resource is intended for the sole purpose of supporting the NHS in adopting or further researching use of CoaguChek XS for self-monitoring.

The information presented here has not been assessed by the independent External Assessment Group and was not considered by the Diagnostic Assessment Committee when making its decision on the use of point-of-care coagulometers for self-monitoring coagulation status in the NHS.

The benefits of using CoaguChek XS for self-monitoring coagulation status reported by the NHS staff involved in the production of this resource include:

  • Increasing the time that the person's international normalised ratio is within therapeutic range, which is associated with a reduction in adverse events such as stroke and major haemorrhage.

  • Releasing time in clinic for people who have more complex problems.

  • Reducing workload on pathology services.

  • Empowering people to take control and ownership of their own healthcare.

  • Reducing visits to anticoagulation services, leading to less work and home life disruption.

  • Allowing people to travel more easily, both within the UK and abroad.

The learning gained from existing users is presented as a series of examples of how NHS sites have adopted and used this technology in current practice rather than suggested best practice. The examples extend beyond the positive guidance recommendations and are presented to assist organisations and clinicians in considering the use of CoaguChek XS for self-monitoring coagulation status in the NHS.

NICE technology appraisal guidance recommends the use of 3 non‑vitamin K antagonist oral anticoagulants (NOACs), apixaban, rivaroxaban and dabigatran etexilate, for preventing stroke and systemic embolism in people with non‑valvular atrial fibrillation. These do not need therapeutic monitoring but may be unsuitable for some people.

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