What Is Coumadin ?

Coumadin (Warfarin) is an oral anticoagulant ("bloodthinner") that is currently used in cardiology and other fields of medicine, to prevent or treat thromboembolic events (improper blood flow, clotting and its effects). Some of these conditions include cerebrovascular accident ("stroke"), atrial fibrillation, blood clots in arteries or veins, pulmonary embolism, severe heart failure, extensive heart attacks, heart valve replacement, and sometimes, following stent placement in a blood vessel.

The use of Coumadin must be monitored closely to ensure correct dosage and to minimize the risk of bleeding due to excessive blood thinning. Until recently, a patient needed to come into the doctor’s office and have his/her blood drawn and sent on to a lab to be analyzed. This process is cumbersome and necessitates blood draw from an arm vein; additionally, results could take up to 48 hours, while the patient may still be taking a dosage that needs to be modified.

Coumadin Clinics

The ACS Coumadin Clinics, the first in the Valley, provide a new finger-stick method of blood analysis, approved by the FDA in 1997. This test is performed in the doctor’s office, eliminates the need for painful blood draws, and ensures that accurate results are available within two minutes. The patient will visit with a trained Registered Nurse (R.N.) or a trained Medical Assistant (M.A. supervised by a physician) each time. Any adjustment to the medication dosage will be made immediately, in consultation with a physician, if necessary, and the patient will go home.

Special Features

The ACS Coumadin Clinics manage the Coumadin therapy of our patients using the Roche Boehringer Mannheim CoaguChek™ Protime/INR system. The monitor has been evaluated for accuracy at our office using controls, and has been certified according to Clinical Laboratory Improvement Amendments (CLIA) regulations. The accuracy and convenience of this equipment is complemented by CoumaCare computer software. This enables us to track the test results efficiently, and prompts us when our patients are due for testing. The CoumaCare program also enables us to run event reports, follow-up reports, and quality assurance (QA) reports on all patients. This multifaceted approach helps us manage and monitor Coumadin patients more carefully and efficiently.

Testing

CS currently offers Coumadin Clinics at nine office locations across the state (Apache Junction, Buckeye, Casa Grande, Gilbert, Gold Canyon, Goodyear, Payson, Phoenix, and Prescott). The Gilbert office manages approximately 1,920 patients a month on Coumadin, and our Apache Junction office follows more than 700 patients a month in their clinic. Each of our clinics is overseen by an R.N. who was trained based on the "Managing Anticoagulant Therapy" seminar sponsored by the Loma Linda Veterans Administration Medical Center in California. (Payson is overseen directly by our physician.
Each patient who enters the program receives one-on-one patient education. We have found this to be very useful, as our patients are much better informed and better able to actively participate in their care.

Coumadin Self-Testing

Encouraged by the level of patient convenience and ease and accuracy of testing, we have now begun Coumadin Self-Testing for suitable patients. We currently have patients, who, having successfully completed a closely supervised training class, are on the self-testing protocol at home. They have their own CoaguChek™ machines and perform their own Protime/INR testing. Each time they check their Protime, they contact the nurse by phone, regarding their results and any dose adjustments that may be necessary. This frees these patients from frequent office visits and allows them to schedule travel and vacations with greater convenience.

Medicare and most other major insurance programs cover the finger-stick method of Coumadin monitoring. Please note that it is not necessary for the patient to see a physician.

Information for Referring Physicians & Patients

If you are a physician and are interested in obtaining additional information on the Coumadin Clinic, or if you have a patient who you would like to refer to the clinic, please contact us at 830-620-1272 or e-mail us.

If you are a patient on Coumadin Therapy and would like more information regarding the Coumadin Clinic, please contact us at 830-620-1272, or e-mail.