Development of a User-Friendly App for Assisting Anticoagulation Treatment
Blood coagulation time is an important factor to consider for postoperative and cardiac disorder patients who have been prescribed anticoagulant coagulant medications. This chapter describes a patient self-management system for assessment of blood coagula
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Introduction Coagulation is the process in which blood changes from a liquid to a gel. The mechanism involves a cascade of reactions in which enzyme precursors are successively and rapidly activated to catalyze the next reaction, ultimately resulting in cross-linking of fibrin polymers and clot formation [1]. The extrinsic coagulation cascade ensues in the following sequence: tissue damage → activation of tissue factor → activation of factor VII → activation of factor X → cleavage of prothrombin to produce thrombin → cleavage of fibrinogen to produce fibrin → and polymerization of fibrin. Anticoagulants are often used in medicine to help prevent blood clots from forming and to reduce the risk of heart attack, stroke, and blockages in arteries and veins [2]. When anticoagulants are prescribed for a patient, it is essential to carry out periodic monitoring of the time it takes the blood to clot using the international normalized ratio (INR) to adjust the dose as necessary [3]. Many patients are advised to carry out the relevant checks themselves using coagulation test strips combined with a suitable reader [4]. Based on these results, the appropriate dosage of anticoagulant should be administered to achieve the required target range. This management process would be facilitated by the use of Coagu app, developed by Appamedix UG in Berlin, Germany [5].
Paul C. Guest (ed.), Multiplex Biomarker Techniques: Methods and Applications, Methods in Molecular Biology, vol. 1546, DOI 10.1007/978-1-4939-6730-8_27, © Springer Science+Business Media LLC 2017
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Johannes Vegt
In 2013, the Coagu app was recognized for its usability by the International Design Centre Berlin and as an example of a particularly user-friendly product on the international Funkausstellung (IFA) [6]. The app draws on a universal design, which means that it can be used by all ages alike. Currently, it is now used by patients in over 70 countries. The evidence shows that greater use of self-monitoring offers clinical and patient benefits and is likely to result in reductions in heart attacks and strokes caused by blood clots [7].
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Materials 1. Smartphone or tablet (see Note 1). 2. Coagu app. 3. Test strips and meter (see Note 2).
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Methods
3.1 Preparation: Determination of INR
1. Insert the test strip into the coagulation meter (Fig. 1). 2. Lightly pierce the tip of a finger. 3. Immediately apply the resulting blood drop to the test strip. 4. After 60 s, the measured value appears on the meter display.
Fig. 1 (A) The figures of the last INR (International Normalized Ratio) measurement gradually fade away over seven days. This reminds the patient to take the next measurement. (B, C) Lightly pierce the top of a finger. (D) Immediately apply resulting blood drop to the test strip that is in the measurement device (see Note 2). (E) After 60 s, the measured value appears on the meter display. (F) The patient enters the INR Value, using a number picker and stores it. (G) The measured and saved Value appears with the actual date on the start p
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