Warfarin therapy is prescribed to 10,000 patients in the County Durham and Darlington region to reduce the risk of strokes, and we are delighted to announce that we now provide a fully integrated INR self-testing service with 4S DAWN, a trusted anticoagulation dosing software supplier to over 300 leading healthcare organisations worldwide.

County Durham and Darlington Foundation Trust is the first Trust to offer a fully automated digital self-monitoring service to its warfarin patients. For patients who are enabled to self-test their INR from home, this means that results are now available immediately in the hospitals anticoagulation software.

The average time it takes a nurse to dose each patients was initially reduced from 5 minutes to 3 minutes, and can now be completed in less than 30 seconds per patient, reducing the burden on our staff.

This has also eliminated the risk of transcribing errors that could potentially occur by staff transferring the data from one system to another.

The ease with which people on warfarin can self-test and remotely and securely update their patient record showcases the role digital solutions can play in futureproofing healthcare across the UK.

In 2014, NICE recommended that self-testing should be extended, but currently only 1% of patients do so.

A 24 month follow up of our INR self-testing service showed that patient’s time in therapeutic range (TTR) had increased from an average of 59% to 76%. When applied to national data this increase would predict to save upto 1,500 strokes per year.

Since its launch, the service has saved 21,000 clinic appointments.  This has released the capacity in clinic so that the  nurses can focus on those more complex patients. This has resulted in a 4% increase in TTR for those unable to self-test.

The self-management approach to warfarin anticoagulant therapy also appeals to the individual circumstances and lifestyles of the patient. Patients are able to select when and where they would like to self-test their INR, and also how they would like to communicate this data with the monitoring system.

One of our patients Derek Jones from Darlington said, “If for any reason you can’t commit to the clinic, because you’re working, going away or just want to live a normal life then this service will really help. I don’t need to take regular time off work, pay for travel or car park charges at the clinic because I’m able to take my own readings and receive my updated dose when it’s convenient for me, without disrupting my normal routine.”

We must work to engage patients and clinicians together around self-management and make those suitable aware of the benefits. Almost all of the 450 patients that enrolled onto our service have stayed for over two years now, as it has developed as a lifestyle choice for them and with them.


Watch this ITV Tyne Tees news clip to hear more from our patient Derek Jones, and how the service enabled him to holiday abroad with his family.