Anticoagulation (warfarin) Monitoring Services
We see patients who need regular monitoring of their anti-clotting or blood thinning medication.
Your medication helps to treat and prevent blood clots and reduce your chances of developing serious conditions such as strokes and heart attacks.
Our service is for patients registered with a GP in Buckinghamshire
Why do I need anticoagulation monitoring?
Blood thinning medication like warfarin thins your blood. You may need to take it if you:
- have had a blood clot in your leg (Deep Vein Thrombosis)
- have had a blood clot in your lungs (pulmonary embolism)
- have an irregular heart beat known as atrial fibrillation.
You may also need to take blood thinning medication to prevent a blood clot if you’re at high risk of having them in the future.
The aim of treatment with warfarin or sinthrome is to thin your blood but not stop it clotting completely. Getting this balance right means your dose of warfarin must be carefully monitored.
Do I need a referral?
Yes. Your GP or a hospital consultant will refer you for anticoagulation monitoring.
Where do I need to go for anticoagulation monitoring?
We run clinics by appointment only at Wycombe and Stoke Mandeville Hospitals, as well as at our community hospitals, health centres and GP surgeries across Buckinghamshire.
If your GP refers you for the first time, you’ll get an appointment letter for the anticoagulant clinic, as well as some information about blood thinning drugs.
If you prefer, we can provide a telephone consultation.
What happens during my appointment?
You’ll normally have a blood test just before your appointment. We’ll tell you about the drugs we think may be suitable for you and where possible, help you choose which anticoagulant will be right for you.
We’ll also explain:
- how the drug works
- how to take then
- what to do if you forget to take it or take too much
- about possible side effects.
We’ll give you information about the drug, as well as an alert card. You’ll normally get a prescription for months supply of your new medication.
Normally we won’t need to see you in hospital again. We’ll write to your GP to tell them which drug you have.
Which anticoagulant medications do you prescribe?
I’m a Warfarin patient, what do I need to do?
If Warfarin is the most suitable drug for you, your follow up will normally be with the clinic. Warfarin needs regular blood test monitoring to adjust how much warfarin you need. The blood test is called the International Normalised Ratio (INR).
We use point of care testing service which means we can see you in a clinic of your choice nearest to your home address. These clinics run at:
- Wycombe Hospital
- Stoke Mandeville Hospital
- some of our community hospitals
- some GP surgeries.
Tell us which clinic you prefer and we can automatically arrange an appointment and further appointments will automatically be made for you.
What does the INR test involve?
We’ll take a finger prick blood test. After you get your blood test result, we’ll tell you how much Warfarin to take and the date for your next blood test. We’ll record this information in your personal oral anticoagulation booklet. Always bring this with you to your clinic appointment.
Find out more about Warfarin including:
- how to take your medication
- possible side effects
- interactions with other medicines
- advice about food and drink
Women may experience heavier periods while taking oral anticoagulants. You may wish to discuss this with your GP, anticoagulant nurse or pharmacist.
Going to the dentist
You must tell your dentist and GP you are on an anticoagulant. Contact your dentist before your appointment as you may need an extra blood test.
In the majority of cases, you can have dental treatment without having your dose adjusted or stopped. Your dentist may ask to see a recent INR test result to provide safe treatment.
How do I get a repeat prescription?
If you are on warfarin
You’ll need to get a test each time you request and get a supply of oral anticoagulants. This will include a review of your blood test results and dose information. We’ll also make sure it’s safe to supply you with more tablets.
When you request a repeat prescription, you must provide information about your INR test results and current dose of oral anticoagulant. You can find this information in your oral anticoagulation therapy record book.
Your community pharmacist will also ask to see this information when they dispense your prescription. If you can not request or collect the prescription yourself, make sure that the person representing you has this information with them. For prescription delivery services, the pharmacist dispensing the prescription should contact you to confirm your INR and current dose. Make sure that you do not run out of tablets and always have at least 1 week’s supply.
If you are on Apixaban, Dabigatran, Edoxaban or Rivaroxaban
The anticoagulant clinic will normally provide your first month of anticoagulant. After this you need to get your prescription from your GP.