A review of point of care technology in the management of thrombophilia

Abstract

The management of thrombophilia patients involves anticoagulation therapy (prophylaxis or treatment). With a short therapeutic window, the effect of oral anticoagulant therapy needs to be monitored to create a balance between bleeding and thrombus formation. PT/INR, APTT and ACT assays have been used to monitor the coagulation cascade. Traditional methods of these assays used visual detection of clot and with changes in technology, the use of optical and mechanical detection system have produced more accurate and reproducible devices, though with limitations. Miniaturization of complex laboratory instruments into portablehand-held devices such as CoaguChek XS and I-STAT have revolutionized personalized medicine. The need for point of care testingin patients self-testing (PST) and patient self–management (PSM) have also shown an enormous impact on survival in thrombophilia patients, though costly. However, with POCT technologies currently undergoing a transformational change in the monitoring of newer anticoagulation drugs the total cost effectiveness of these technologies in personalized medicine cannot be ignored.

Keywords: Thrombophilia, Point-of-care testing, Coagulometers, Thrombosis, Patient-self-management, Patient-self-testing