Multidisciplinary Assessment of Technology Centre for Healthcare, Department of Information Systems and Computing, Brunel University, Uxbridge, Middlesex UB8 3PH, UK.
BMC Health Serv Res. 2011 Feb 3;11:25. doi: 10.1186/1472-6963-11-25.
Patients on oral anticoagulant therapy (OAT) require regular testing of the prothrombin time (PT) and the international normalised ratio (INR) to monitor their blood coagulation level to avoid complications of either over or under coagulation. PT/INR can be tested by a healthcare professional or by the patient. The latter mode of the testing is known as patient self-testing or home testing. The objective of this study was to elicit patients' perspectives and experiences regarding PT/INR self-testing using portable coagulometer devices.
Internet blog text mining was used to collect 246 blog postings by 108 patients, mainly from the USA and the UK. The content of these qualitative data were analysed using XSight and NVivo software packages.
The key themes in relation to self-testing of OAT identified were as follows: Patient benefits reported were time saved, personal control, choice, travel reduction, cheaper testing, and peace of mind. Equipment issues included high costs, reliability, quality, and learning how to use the device. PT/INR issues focused on the frequency of testing, INR fluctuations and individual target (therapeutic) INR level. Other themes noted were INR testing at laboratories, the interactions with healthcare professionals in managing and testing OAT and insurance companies' involvement in acquiring the self-testing equipment. Social issues included the pain and stress of taking and testing for OAT.
Patients' blogs on PT/INR testing provide insightful information that can help in understanding the nature of the experiences and perspectives of patients on self-testing of OAT. The themes identified in this paper highlight the substantial complexities involved in self-testing programmes in the healthcare system. Thus, the issues elicited in this study are very valuable for all stakeholders involved in developing effective self-testing strategies in healthcare that are gaining considerable current momentum particularly for patients with chronic illness.
接受口服抗凝治疗（OAT）的患者需要定期检测凝血酶原时间（PT）和国际标准化比值（INR），以监测其凝血水平，避免过度或不足凝血带来的并发症。PT/INR 可由医疗保健专业人员或患者进行检测。后者的检测模式被称为患者自我检测或家庭检测。本研究的目的是了解患者使用便携式凝血仪进行 PT/INR 自我检测的观点和体验。
本研究采用互联网博客文本挖掘技术，收集了来自美国和英国的 108 名患者共 246 篇博客文章。使用 XSight 和 NVivo 软件包对这些定性数据的内容进行了分析。
与 OAT 自我检测相关的主要主题如下：报告的患者获益包括节省时间、个人控制、选择、减少旅行、更便宜的检测和安心。设备问题包括高成本、可靠性、质量以及学习如何使用设备。PT/INR 问题主要集中在检测频率、INR 波动和个体目标（治疗）INR 水平上。其他主题还包括在实验室进行 INR 检测、在管理和检测 OAT 过程中与医疗保健专业人员的互动以及保险公司在获取自我检测设备方面的参与。社会问题包括进行 OAT 检测的痛苦和压力。
PT/INR 检测患者博客提供了有见地的信息，可以帮助理解患者自我检测 OAT 的体验和观点的本质。本文确定的主题突出了自我检测计划在医疗保健系统中所涉及的实质性复杂性。因此，本研究中引出的问题对于参与制定在医疗保健中具有重要意义的自我检测策略的所有利益相关者都非常有价值，特别是对于患有慢性疾病的患者。
