How is your experience with point-of-care INR systems for home monitoring of vitamin K antagonists?

Point of care (POC) INRs are reliable and can be used to monitor patients once their INRs have been stabilized on warfarin. In fact, there is data on better time in the therapeutic range for self-testing and also self-management of dosing. However, this needs to be done in conjunction with a warfarin anticoagulation clinic.

There are two instances where they may not be reliable. 1) Patients on bridging low molecular heparin: the POC devices do not have a heparin neutralizer (unlike the PT reagen...