Prothrombin testing helps determine how quickly blood clots, important to know when someone’s taking blood-thinning drugs. While the FDA labels some for “home” use, Russell doesn’t think prothrombin self-monitoring is a good idea.
“This test is best done by trained personnel because the results require careful analysis, and errors in testing can lead to pretty substantial complications,” he says. Besides, he points out, “prothrombin tests are expensive: about $1,000 and then (like glucose tests) a constant investment in test strips.”
“Home” prothrombin tests have been a lifesaver in doctors’ offices. “Since we’ve started using prothrombin kits in our on-site Medical Center—as opposed to drawing blood and sending it to a lab—we’ve seen a real improvement in the quality of patients’ Coumadin dosing. It’s not out of range as often as it could be when we had to wait for overnight lab results, and complications are considerably less. Physicians can now make immediate, very fine adjustments to someone’s medication dosage,” says Russell.
Beyond Test Strips
There are other home kits using test strips, but Russell finds very few that those 62-plus really need. “You can do home cholesterol testing, but you might as well have it done during your regular physical.”
Where he sees some interesting developments for average consumers is medical devices they can use themselves. One example he offers is home blood pressure (BP) monitoring which he says generally is a good thing.
As with all home tests, be careful about interpreting results. “Let’s say you have a headache, check your BP, and see your pressure’s up 40 points. Your headache could be the cause of your higher pressure, but that pressure may also have gone up just out of concern over your headache. It’s best to check with your doctor for guidelines,” Russell says.
Patients with heart rhythm disorders might want to discuss home event monitoring with their physicians. “When patients complain of rhythm problems, doctors often recommend wearing a 24-hour heart monitor, but it’s often like taking your car to the mechanic—that ‘weird sound’ disappears as soon as you bring it in. Cardiac events don’t happen every day. It’s a matter of statistics,” says Russell.
But now there are cardiac “home event monitors” that the cardiologist provides which you can wear for weeks. “If you have symptoms, you hit a button on or near the phone and it connects you to a phone line where a cardiac tech can see an EKG strip, then give that strip to a cardiologist to review,” he says.
The Key to Home Testing
Check with your insurer as to which home test and devices they’ll cover. If they give you a choice, talk to a health expert including the pharmacist as to which is a good investment.
Finally, Russell urges everyone to remember, “The main disadvantage to home testing is it doesn’t come with counseling, the way office testing does.” As an example he points to diabetes monitoring. “The beauty of the Erickson HealthSM approach to geriatrics is we address the whole patient, not just a specific disease, like diabetes. If people are going to a special event and want to eat cake, that diabetes monitor and their log book is just part of how we help them find a way to eat cake and still maintain their health.”
He concludes: “Home testing is never a substitute for a physician’s assessment and a treatment plan the doctor can develop for you. Test results can be misleading or even dangerous if they’re not connected to a doctor’s advice and a total wellness program.”